bluuebunny/crossref_metadata_2025 huggingface dataset:
Foreign Direct Investment (FDI) and Its Impact on Regional Development
Authors: Ali Walid
Published: February 2024

Except for a few recent works, the study of the articulation between regional direct investment and economic development in a country like Tunisia has remained, at best, at the stage of theoretical argument. The major contribution of this work is to undertake the empirical exploration of the black box constituted by regional investment so far in order to explain the weakness of national financial resources and the low rate of economic growth that results from it. In this context, the authors first establish basic results by estimating a static panel model, then they consider dynamic panel estimates through the use of the GMM-system method developed by Blundell and Blond for six Tunisian regions (GT, NE, NO, CE, CO, and South) for the period covering 22 years from 2000 to 2021. As a last resort, they consider the non-stationary panel perspective. The panel unit root tests of Levin, Lin, and Chu; Pesaran and Shin; and Hadri indicate that the series are integrated of Order 1.
Over-rotated Rieger flap for a large lateral nasal tip defect reconstruction
Authors: De Piano Ernesto , Rubegni Pietro , Falcinelli Francesca
Published: February 2024

A 65-year-old man presented with a Melanoma in situ of the nasal tip. Complete excision was achieved after 2 “Slow Mohs” stages, resulting in a circular 2.7 X 2.4 cm defect involving the right lateral nasal tip, dorsum and sidewall and extending to the perichondrium.
Acute Kidney Injury in Acute Myocardial Infarction and Its Outcome at 3 and 6 Months
Authors: Kaur Jaspreet , Bhardwaj Nidhi , Reddy Sreenivas , D'Cruz Sanjay
Published: February 2024

Epidemiological data on the prevalence of acute kidney injury (AKI) in acute coronary syndrome are sparse, with most studies having been conducted retrospectively. This study prospectively analyzed the incidence of AKI in patients with acute myocardial infarction (AMI) and to identify the risk factors for AKI and their renal outcome at 3 and 6 months. This was a prospective and observational study, which enrolled 120 patients presenting with their first episode of AMI to our hospital and consented to the study. Renal function tests were performed at admission, at 48 h, and at follow-up at 3 and 6 months. The majority of the patients underwent a percutaneous coronary intervention (59.2%), 21.7% received thrombolytic therapy, and 19.2% were managed conservatively. At 48 h, 11 patients had AKI. At 3 months, 8 patients had died, and renal dysfunctions were seen in 9 out of 112 patients. At 6 months, 12 patients out of 112 had renal dysfunction. There was no difference in the incidence of AKI in patients with an estimated glomerular filtration rate above and below 60 mL/min/1.73 m2. Killip Class 4 and diabetes mellitus were associated with an increased incidence of renal dysfunction in AMI patients. The type of treatment and the use of a contrast agent in the coronary intervention did not affect the development of AKI. According to this study, if indicated, a percutaneous coronary intervention should not be denied to patients for fear of developing AKI. This needs to be examined in larger randomized trials.
Relationship between High-density Lipoprotein Cholesterol and Insulin Resistance in Non-diabetic Chronic Kidney Disease Patients
Authors: El-Hendy Yasser Abdel-Monem , Ismail Mabrouk Ibrahim , Borai Maher Mohamed , Abdelhamid Walid Ahmed Ragab
Published: February 2024

Insulin resistance is linked to cardiovascular disease (CVD), even in non-diabetic patients. Therefore, insulin resistance contributes to the development of CVDs, which are the most important cause of morbidity and mortality in chronic kidney disease (CKD) and patients receiving dialysis replacement therapy. Furthermore, CKD greatly affects the enzyme activities responsible for the metabolism of high-density lipoprotein (HDL), causing an abnormal composition and function of HDL, which results in the loss of the anti-inflammatory effect of HDL and its protective effect against CVD. The study aimed to find the relationship between HDL-C, inflammation, and insulin resistance in nondiabetic CKD patients undergoing different modalities of treatment. This prospective cross-sectional comparative study included 80 subjects divided into the control group (20 healthy participants), Group 1 (15 predialysis CKD patients on conservative treatment), Group 2 (10 peritoneal dialysis patients), and Group 3 (35 hemodialysis patients). A full history, medical examination, and a laboratory investigation were carried out on all subjects from June 2018 to June 2019. The patient groups had significantly lower HDL and higher serum insulin than the control group. HDL was negatively correlated with the Homeostatic Model Assessment of Insulin Resistance. There was a strong negative association between HDL and insulin resistance in CKD patients. Therefore, lifestyle modifications and dyslipidemia treatment in CKD might help to prevent cardiovascular events even in nondiabetic nonobese CKD patients.
Prevalence and Risk Factors of New-onset Diabetes after Transplant in East Africans
Authors: Nasir Salsabil Osman , McCarthy Helen , Mohamed Ahmed Ihab Abdel-Rahim
Published: February 2024

Very little is known about the prevalence of new-onset diabetes after transplant (NODAT) in sub-Saharan and Eastern Africans. Most of the data are related to African Americans and to North and South Africans. The aims of this study were to examine the prevalence of NODAT in Sudanese renal transplant recipients, compare it with the published literature, and identify the risk factors for developing NODAT. In total, 150 patients who received a living-related kidney transplant between January 2015 and January 2016 were included in this study. Patients with diabetic nephropathy and pretransplant diabetes were excluded. Follow-up was for 2 years after the transplant. The variables studied were age, sex, body mass index, a family history of diabetes mellitus (DM), pretransplant steroid therapy, dyslipidemia, and hepatitis C virus infection. Twenty- three patients (15.3%) developed NODAT during the study period. The mean age of the patients who developed NODAT was 39 ± 14 years, and the mean time to develop NODAT was 5.78 ± 5.9 months. In the multivariate analysis, the risk factors for developing NODAT were a family history of DM (P = 0.01) and pretransplant steroid therapy (P = 0.01). The prevalence of NODAT in this study was 15.3%, which is in line with the reported literature from North Africa. However, it was significantly lower than the reported prevalence in African Americans.
Clinicopathological Profile of Immunoglobulin A Nephropathy: A Study from Northeast India
Authors: Kalita Pranjal , Mishra Jaya , Dey Biswajit , Raphael Vandana , Lyngdoh Monaliza , Barman Himesh , Mishra Animesh
Published: February 2024

Immunoglobulin A (IgA) nephropathy is the most common primary glomerulopathy, with wide variation in its prevalence as well as clinical symptoms. Among the laboratory parameters, increased serum creatinine (SCr) levels, mean arterial pressure (MAP), and a decreased estimated glomerular filtration rate (eGFR) point toward poorer renal function. The Oxford 2016 scoring system for IgA nephropathy identified various histopathological variables, which serve as indicators of renal outcomes. There is a paucity of studies on the prevalence as well as the various clinical laboratory parameters correlating with the 2016 Oxford scoring system in northeastern India. The present study showed that IgA nephropathy was more common in the second and third decades, more prevalent in females, and mostly presented with edema. Nephrotic proteinuria, higher SCr, MAP, and decreased eGFR levels at presentation suggested poorer renal function in most subjects. The endocapillary hypercellularity, segmental sclerosis, tubular atrophy, and crescent variables of the 2016 Oxford scoring system showed a statistically significant relationship with various laboratory parameters at presentation.
Single-Dose Enoxaparin for Portomesenteric Venous Thrombosis Prophylaxis after Sleeve Gastrectomy
Authors: Nofal Mohammad Nebih , Wadi Waleed I. , Yousef Ali J. , Rashdan Mohammad Z. , Alkhasawneh Mahmoud H. , Dwairi Rami N. , Alhalasa Yousef F. , Majali Balqees M. , Abushaqra Raghad K.
Published: February 2024

Introduction:

Portomesenteric venous thrombosis (PMVT) may complicate sleeve gastrectomy. We believe that single dose of enoxaparin postoperatively can reduce the risk of PMVT.

Objective:

The objective was to study the outcomes of enoxaparin single dose compared to other perioperative prophylactic doses in preventing PMVT.

Methods:

Participants included 590 patients who underwent laparoscopic sleeve gastrectomy (LSG). These retrospective cohort data were collected from patient medical charts after bariatric surgery. Patients were followed up in the close postoperative period and at 1, 3, 6, 12, and 18 months. Descriptive statistical analysis was carried out. The objective was to estimate the incidence of PMVT with postoperative single 40 mg subcutaneous enoxaparin prophylactic regimen.

Results:

From January 2017 to December 2021, 590 patients with obesity underwent LSG. Five patients developed PMVT with an estimate incidence of 0.85%. Three patients had unexplained tachycardia and three patients had postoperative bleeding.

Conclusions:

Single-dose enoxaparin 40 mg is an effective thrombosis prophylaxis without increasing risk of bleeding.
Safety of Hyperbaric Medicine in Clinical Scenarios
Authors: Mago Vishal
Published: February 2024

Hyperbaric therapy is generally considered a safe therapy for the treatment of wounds, mucormycosis, and orthopedic injuries. It is fraught with complications such as barotrauma, pulmonary toxicity, fire hazards, and claustrophobia. This article discusses the safety protocols and preventive aspects on usefulness of this new emerging therapy.
The Impact of Coronavirus Crisis on Human Interpersonal Relationships among AlAhsa Population
Authors: Khan Abdul Sattar , Alnefaie Bayan Taher , Al-Ali Danah Sami , Alhajji Zainab Yousif , Almusallam Saja Ali , Alghannam Fadak Noori
Published: February 2024

Background:

Home quarantine during the coronavirus disease 2019 pandemic was a clear cause of loss of communication and a lot of conflicts between individuals, which had adverse consequences on people’s relationships.

Objective:

This study aims to assess the effect of lockdown on interpersonal relationships in AlAhsa community.

Methods:

A cross-sectional study was conducted during 2020–2021 with 306 participants in AlAhsa, the eastern region of Saudi Arabia. The data were collected using an online survey to explore the effect of lockdown on interpersonal relationships.

Results:

The study demonstrates that (61.8%) of the participants reported that their relationships were affected during lockdown, (61.4%) of them were affected negatively, with a higher rate among the unemployed and students (73.1%) and (64.8%), respectively. About 38.6% of the individuals were positively affected.

Conclusion:

Most of the participants identified that quarantine affected their interpersonal relationships negatively, which were impacted variably by different demographical statuses.
Correlation of Serum Uric Acid Levels with Certain Anthropometric Parameters in Prediabetic and Drug-naive Diabetic Subjects
Authors: Tiwari Ritu , Verma Shivam , Verma Narsingh , Verma Dileep , Narayan Jagdish
Published: February 2024

Introduction:

Uric acid is produced during the metabolism of nucleotide and adenosine triphosphate and contains the final product of human purine metabolism. It acts both as an antioxidant and pro-inflammatory marker and has a positive association with visceral fat in overweight subjects. The aim of the present study is to find an association of uric acid level with certain anthropometric parameters in subjects having type 2 diabetes.

Materials and Methods:

The study included 124 urban drug-naive diabetic Indian subjects above 18 years of age from the general population of the city of North India. Uric acid concentrations were estimated by the uricase method. Fasting plasma glucose (FPG) concentrations were estimated by the glucose oxidase-peroxidase method. Anthropometric measurements and information on lifestyle factors and disease history were collected through in-person meeting.

Results:

All participants of the study subjects had a body mass index (BMI) of more than 23.5. BMI, waist-to-hip ratio (WHR), waist-to-height ratio, waist circumference, neck circumference, weight, age, sagittal abdominal diameter (SAD), skinfold thickness, and body roundness index were positively correlated with the serum uric acid level. The correlation of weight, BMI, SAD, and WHR was statistically significant.

Conclusion:

We found that serum uric acid level increases as body fat content increases. Statistical data show remarkable results for a significant correlation of uric acid level with BMI, WHR, SAD, and FPG. Hypertrophy occurs as a result of inflammatory processes and oxidative stress when the supply of energy starts to exceed the storage capacity of adipocytes, as a result, adipokines such as interleukin (IL)-1, IL-6, and tumor-necrosis factor-alpha are released more frequently which lead to low-grade chronic inflammation. Uric acid levels are much lean toward visceral obesity than overall body fat content.
Awareness and Knowledge of Scabies and Ringworm among Parents of School-age Children in Calabar, Cross River State, Nigeria: Implications for Prevention of Superficial Skin Infestations
Authors: Emanghe Ubleni Ettah , Imalele Edema Enogiomwan , Ogban Godwin Ibitham , Owai Promise Akugom , Abraka Bode Akashie
Published: February 2024

Context:

Risk factors for the persistence of superficial skin infestations are prevalent in humid tropical environments, which are favorable for breeding of the causative vector mite Sarcoptes scabiei (ectoparasite) and dermatophyte fungi.

Aim:

This study aimed at assessing the awareness and knowledge of childhood scabies and ringworm infestations among parents in Calabar, a highly humid rainforest tropical environment.

Settings and Design:

Cross-sectional study design and systematic random sampling were used to recruit school-age children in selected primary schools in Calabar.

Materials and Methods:

Researcher-driven administration of a structured questionnaire was conducted to obtain quantitative data from parents of recruited children.

Statistical Analysis Used:

Chi-square was used to assess factors associated with ever hearing or seeing scabies and ringworm infestations. Statistical significance was set at P < 0.05.

Results:

One hundred and eighty-two (56.7%) and 218 (67.9%) of the respondents had heard of or seen scabies and ringworm infestation. Among respondents that were aware of scabies, 53.3% knew of the cause, 50.5% were aware of the risk factors while 68.1% and 78.0% knew their treatment and prevention, respectively; 98.6%, 60.6%, 76.6%, and 80.7% of respondents knew the cause, risk factors, treatment, and prevention of ringworm infestation, respectively. Fathers with at least secondary school literacy level and sharing beds were significantly associated with awareness of scabies.

Conclusion:

There is a suboptimal level of awareness and knowledge of two of the most common superficial skin infestations among parents of primary school children in the study setting. There is a need to redouble our effort at sensitization of parents toward improved awareness of these common infestations.
Role of Optical Coherence Tomography in Chronic Spontaneous Coronary Artery Dissection-Diagnosis and Management
Authors: Maqableh Ghaith Mohammad Yousef , Khan Kumail Abbas , Shahid Farhan , Khan Sohail Q.
Published: February 2024

Spontaneous coronary artery dissection is an underdiagnosed cause of acute coronary syndrome, often occurring in younger females. Such a diagnosis should always be considered in this demographic. In this case report, we focus on the importance of optical coherence tomography in the diagnosis and management of this condition in the elective setting.
Morphological Cardiac Alterations in Liver Cirrhosis
Authors: Srinivasamurthy Banushree Chandrasekhar , Saravanan Sanjay P. , Marak Fremingston K. , Manivel Prakash , Bhat Ramachandra V. , Mathiyazhagan Dharanya
Published: February 2024

Background:

Cirrhosis can cause various cardiac complications and severely affect the prognosis of the patient suffering from cirrhosis. Anatomical, morphological variations in the heart of patients with liver cirrhosis in the absence of known cardiac disease has not been well described. There is a paucity of studies in the literature on cardiac alterations in cirrhosis. Early detection of known cardiac alterations can further help in improving the quality of life.

Materials and Methods:

A cross-sectional descriptive study was conducted in the departments of pathology and forensic medicine of our institution. An autopsy-based prospective study of forty consecutive patients with final diagnosis of liver cirrhosis were included. Patients with a known history of cardiac disease/anomaly were excluded from the study. Macroscopic and microscopic changes in the heart and coronaries were noted and statistically analyzed.

Results:

Analysis of the hearts on gross examination showed cardiomegaly in 31 patients (77.5%). All cases had left ventricular hypertrophy. Endocardial thickening was seen in 22 patients (55%). Calcified mitral valve was seen in 9 patients (22.5%).

On microscopy, apart from hypertrophy, the pathological changes like interstitial oedema (47.5%), fibrosis (45%), cardiac muscle disarray (87.5%), fatty infiltrate (10%), pericarditis (5%), and severe coronary artery atherosclerosis (17.5%) were seen in the patients.

Conclusion:

Knowledge about the involvement of the heart in liver cirrhosis is essential for both the physician and the surgeons to prevent adverse outcomes during liver transplantation and can further help in improving the quality of life of the patient.
Clinical Evidences and Pathophysiology of Cardiac Arrhythmia in the Era of Coronavirus Disease-2019
Authors: Hamad Adel Khalifa Sultan
Published: February 2024

The coronavirus disease-2019 (COVID-19) is primarily caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has been a challenge to the clinician. Epidemiological studies unveiled the involvement of the cardiovascular system during the course of SARS-CoV-2 infection. The cardiac complications in patients with COVID-19 include myocarditis, heart failure, acute coronary syndrome, and cardiac arrhythmia. The pathophysiological states of the disease and multiple concurrent medications (unfamiliar to the clinicians) lead to a significant threat to arrhythmia. This review article hopes to elucidate the mechanisms of arrhythmias in COVID-19.
Impact of COVID-19 on Workload and Workflow in Echocardiography Unit in a Tertiary Care University Hospital
Authors: Kossaify Mikhael , Kanj Hazar , Tarabay Christina , Kossaify Antoine
Published: February 2024

Background:

The COVID-19 pandemic is a new unexpected worldwide condition with a heavy burden on health-care institutions and health-care workers.

Objective:

We sought to examine the impact of COVID-19 on workload and workflow in the echocardiography unit in a tertiary care university hospital.

Methods:

We conducted a monocentric observational study, evaluating workload and workflow during the COVID-19 year relative to the previous year.

Results:

The findings show a substantial reduction in workload (55.20%) along with significant changes in workflow in the echocardiography unit during the pandemic. Changes in workflow involved measures implemented for protection, changes in echo indications which became more selective, changes in echo pattern, reduction in human flow in echocardiography laboratory, delays in reporting and archiving, and changes in training and teaching.

Conclusion:

COVID-19 pandemic had a substantial impact on the echocardiography unit, with a significant reduction in workload and considerable changes in workflow. In the future, it is essential to be better prepared as individuals, health-care workers, health-care institutions, and the general community, to deal better with any potential “invisible enemy.”
Clinical Characteristics and Outcome of Percutaneous Coronary Intervention in Yemeni Patients
Authors: AL-Maimoony Taha , AL-Sageer Nora , Alnajjar Mervat , Ali Kaid Mohammed Ghaleb , Rajeh Mohammed , Al-Motarreb Ahmed Lutf
Published: February 2024

Background:

Percutaneous coronary intervention (PCI) is increasingly used in the management of acute coronary syndromes (ACSs). PCI has decreased the demand for coronary artery bypass grafting, and more patients with ACS are now undergoing PCI. No previous data about the characteristics and outcome of patients performing PCI in Yemen. This study aimed to assess the patient presentation, characteristics, and outcome among Yemeni patients having PCI in the Military Cardiac Center.

Methods:

All patients who underwent PCI either primary or elective in the Military Cardiac Center in Sanaa City were included over 6 months. Clinical, demographic, procedural, and outcome data were extracted and analyzed.

Results:

During the study period, 250 patients underwent PCI. The mean ± standard deviation age was 57 ± 11 years, with 84% being male. Of all the patients, 61.6% (156) smoked tobacco, 56% (140) had hypertension, 37% (93) had Type 2 diabetes, 48.4% (121) had hyperlipidemia, and 8% (20) had a family history of ischemic heart disease. Coronary artery presentation was in the form of acute ST-elevation myocardial infarction at 41% (102), non-STEMI at 5.2% (58), stable angina at 31% (77), and unstable angina at 5.2% (13). Coronary artery interventions were elective PCI in 81% (203), emergency in 11% (27), and urgent in 8% (20) with only 3% radial artery access and 97% femoral access. PCI was mainly in the left anterior descending artery in 82% (179), right coronary artery in 41% (89), left circumflex artery in 23% (54), and left main in 1.25% (3). All stents were drug-eluting stents during the registry time. Complication occurred in 17.6% (44) and case fatality was 2% (5).

Conclusions:

Despite the current situation in Yemen, PCI was performed with success in a large number of patients with a low incidence of inhospital complications and mortality that is comparable to high- or middle-income settings.
Clinical-Epidemiological Profile and Factors Related to the Mortality of Patients with Nontuberculous Mycobacteria Isolated at a Reference Hospital in Ceará, Northeastern Brazil
Authors: De Lima Mota Matheus Alves , De Melo David Mendes , Christyan Nunes Beserra Francisca Lillyan , Filho Gerardo Albino Nogueira , Pinto Lílian Macambira , De Jesus Souza Raabe , Da Silva Sousa Sandrirla , Mota Rosa Salani , Da Justa Pires Neto Roberto , Do Jesus Silva Leit Terezinha
Published: February 2024

Background:

There is a significant shortage of official records that enable estimating the real prevalence of nontuberculous mycobacteria (NTM) infections in Brazil. The study aims to investigate the clinical, laboratory, and epidemiological aspects of patients with NTM isolation at an infectious diseases reference hospital, and to identify factors associated with mortality.

Methods:

This was an observational study in which clinical, epidemiological, and laboratory aspects were evaluated in patients with NTM isolated at care in Hospital São José, located in Northeastern Brazil, from 2005 to 2016. The records of the reference laboratory for NTM isolates were searched from the culture results of patients. Afterward, the medical records of the patients were reviewed. The analytical assessment was conducted by the Mann–Whitney and Fisher's exact test. The adopted level of significance was 5%.

Results:

A total of 69 patients were described, with a predominance of males (73.9%). The main clinical forms identified were: pulmonary (60.9%) and disseminated (27.5%). The most frequently NTM identified were Mycobacterium avium (24.6%) and Mycobacterium fortuitum (10.1%). Forty-eight (69.6%) patients had HIV infection. The mortality was 24.6%, and the risk factors for deaths identified were: origin from outside the metropolitan region; weight loss; HIV infection; anemia; hyperbilirubinemia; increased serum glutamic-oxaloacetic transaminase, alkaline phosphatase, lactate dehydrogenase; and impaired renal function. Among the patients with HIV, the main changes related to death were: lower counts of CD4+ and CD8+ T lymphocytes.

Conclusion:

Maintaining constant vigilance regarding the possibility of NTM infection is required, namely in patients co-infected with HIV/AIDS.
Targeting Bedaquiline Mycobacterial Efflux Pump to Potentially Enhance Therapy in Mycobacterium Abscessus
Authors: Martin Anandi , Bouyakoub Yasmine , Soumillion Kate , Mantu Eléonore Ngyuvula , Colmant Alexandre , Rodriguez-Villalobos Hector
Published: February 2024

Background:

Mycobacterium abscessus is notorious for being intrinsically resistant to most antibiotics. Antibiotic efflux is one of the mechanisms used by M. abscessus to pump out antibiotics from their cells. Inhibiting efflux pumps (EPs) can be an attractive strategy to enhance the activity of drugs. The objective of this study is to determine the activity of EP inhibitors (EPIs) to enhance the efficacy of the new drug bedaquiline against M. abscessus clinical isolates.

Methods:

A total of 31 phenotypically and genotypically identified M. abscessus subsp. abscessus, M. abscesss subsp. massiliense, and M. abscessus subsp. bolletii clinical isolates were studied. The contribution of EPs was determined by investigating the minimum inhibitory concentration (MIC) levels of bedaquiline reduction in the absence and presence of EPIs verapamil and reserpine using the resazurin microtiter assay.

Results:

The observed bedaquiline MIC reduction by verapamil was observed in 100% isolates and by reserpine in 54.8% isolates. Bedaquiline MIC was 4–32-fold using verapamil with M. abscessus subsp. bolletii showing the highest fold change and between 2- and 4-fold using reserpine.

Conclusions:

The results obtained in this study confirm that bedaquiline MIC decreased in the presence of EPIs verapamil and reserpine in clinical isolates of M. abscessus. Verapamil was the most effective EPI. As shown in previous studies, verapamil may have clinical potential as adjunctive therapy to enhance the effect of bedaquiline.
Structural Modification of a Novel Inhibitor for Mycobacterium Enoyl-Acyl Carrier Protein Reductase Assisted by In Silico Structure-Based Drug Screening
Authors: Taira Junichi , Nagano Toshiki , Kitamura Mitsuru , Yamaguchi Miho , Sakamoto Hiroshi , Aoki Shunsuke
Published: February 2024

Background:

Mycobacterium tuberculosis enoyl-acyl carrier protein reductase (mtInhA) is involved in the biosynthesis of mycolic acids, a major component of mycobacterial cell walls, and has been targeted in the development of anti-tuberculosis (TB) drugs. In our previous in silico structure-based drug screening study, we identified KES4, a novel class of mtInhA inhibitor. KES4 is composed of four ring structures (A–D-rings) and molecular dynamic simulation predicted that the D-ring is essential for the interaction with mtInhA.

Methods:

The structure–activity relationship study of the D-ring was attempted and aided by in silico docking simulations to improve the mtInhA inhibitory activity of KES4. A virtual chemical library of the D-ring-modified KES4 was then constructed and subjected to in silico docking simulation against mtInhA using the GOLD program. The candidate compound showing the highest GOLD score, referred to as KEN1, was synthesized, and its biological properties were compared with those of the lead compound KES4.

Results:

We achieved the synthesis of KEN1 and evaluated its effects on InhA activity, mycobacterial growth, and cytotoxicity. The antimycobacterial activity of KEN1 was comparable to that of the lead compound (KES4), although it exhibited superior activity in mtInhA inhibition. \

Conclusions:

We obtained a KES4 derivative with high mtInhA inhibitory activity by in silico docking simulation with a chemical library consisting of a series of D-ring-modified KES4.
Disseminated Pulmonary Mucormycosis with Concomitant Tuberculosis Infection in a Diabetic Patient
Authors: Ramesh Priyamvadha , Kaur Gurmeet , Deepak Desh , Kumar Prabhat
Published: February 2024

Patients with diabetes are often susceptible to various opportunistic infections such as tuberculosis and mucormycosis. However, the occurrence of both these infections simultaneously is rare. We present one such case of pulmonary tuberculosis with disseminated pulmonary mucormycosis in a patient with diabetes, which was successfully managed.
Are We Witnessing a Paradigm Shift in Leprosy
Authors: Pathania Vikas , Singh Jatinder , Sinha Anwita , Kothari Rohit , Baveja Sukriti , Shankar Prerna
Published: February 2024

Hansen's disease is a chronic infectious granulomatous disease with varied clinical presentation. In the postelimination era, histoid Hansen's disease is an important emerging lepromatous subset known to mimic varied dermatoses, thereby making clinical diagnosis difficult and often delayed. We report two cases of histoid Hansen's disease bereft of clinical cardinal signs of leprosy.
Epidemiological Profile and Surveillance Activity of Tuberculosis in South Batinah, Oman, 2017 and 2018
Authors: Al Mayahi Zayid K. , AlAufi Ibtisam , Al Ghufaili Badriya , Al Balushi Zawan , Al Mughazwi Zakiya , Mohammed Emad , Essa Rahmdil , Yousif Haga M. , Al Mayahi Adhraa K. , Hattali Azza Al , Ghafri Fakhriyah Al , Shaqsi Nasser Al , Salim Khalid , Elmutashi1 Hamid A , Yaquobi Fatma Al
Published: February 2024

Background:

Understanding the current surveillance activity and the challenges is important to ensure a continuous success toward the elimination goal for tuberculosis (TB). South Batinah Governorate (SBG) ranked the fourth on the top reporting governorates in the period 2010–2016 in Oman. The objective of this study is to describe the epidemiological profile and activities of the surveillance program of TB in the SBG in the years 2017 and 2018.

Methods:

A retrospective quantitative analysis and a qualitative review were performed to the surveillance data present in the department of disease surveillance and control in the SBG in the years 2017 and 2018.

Results:

A total of 39 pulmonary TB (PTB) and 21 extrapulmonary TB (EPTB) cases were diagnosed in 2017 and 2018. More Omanis (22, 56.4%) were diagnosed with PTB compared to non-Omanis; however, the EPTB was solely diagnosed among Omanis (P < 0.001). Majority of the TB patients (35%) were between 30 and 49 years. More than 50% of the TB cases of both the types were diagnosed in <3 months, and the median of diagnosis delay was 33.5 (standard deviation = 95.5). Bacillus Calmette–Guérin vaccine scar was present in only 20.5% of the PTB patients, compared to 57.1% of EPTB (P = 0.004). Patients with PTB presented mainly with cough (31, 79.5%), loss of weight and appetite (25, 64.1%), and fever (22, 56.4%). Enlarged lymph nodes and loss of weight and appetite were the common symptoms among EPTB patients, 38.1 for each (P < 0.001). Staffing, incomplete notifications, difficulty in tracing the results, and absence of regular feedbacks are the major existing challenges.

Conclusion:

SBG continues to sustain low incidence rate of tuberculosis; however, additional strategies are urgently required for further reduction. Hence, the priority is to enhance all essential components of the surveillance system at this stage.
Performance of Mali's Biosafety Level 3 Laboratory in the External Quality Assessment in Preparedness of Laboratory Accreditation and Support to Clinical Trials
Authors: Coulibaly N , Kone B , Sanogo M , Togo ACG , Diarra B , Sarro YS , Cisse AB , Kodio O , Coulibaly G , Kone M , Baya B , Maiga M , Dabitao D , Belson M , Dao S , Diallo S , Diakite M , Babana AH , Doumbia S
Published: February 2024

Background:

The external quality assessment (EQA) or external quality control is an evaluation conducted by a certified external organization to inquire about the quality of the results provided by a laboratory. The primary role of EQA is to verify the accuracy of laboratory results. This is essential in research because research data should be published in international peer-reviewed journals, and laboratory results must be repeatable. In 2007, the University Clinical Research Center (UCRC's) biosafety level 3 (BSL-3) laboratory joined the EQA program with the College of American Pathologists in acid-fast staining and culture and identification of mycobacteria as per laboratory accreditation preparedness. Thus, after 11 years of participation, the goal of our study was to evaluate the performance of our laboratory during the different interlaboratory surveys.

Methods:

We conducted a descriptive retrospective study to evaluate the results of UCRC mycobacteriology laboratory from surveys conducted during 2007 and 2017.

Results:

Of the 22 evaluations, the laboratory had satisfactory (100% of concordance results) in 18 (81.8%) and good (80% of concordance results) in 4 (18.2%). Overall, the laboratory was above the commended/accepted limits of 75%.

Conclusion:

So far, UCRC's BSL-3 performed well during the first 11 years of survey participation, and efforts should be deployed to maintain this high quality in the preparedness for laboratory accreditation and support to clinical trials.
The Activity-Based Cost of Drug-Susceptibility Test of Mycobacterium tuberculosis Through Kit SIRE Nitratase® Plastlabor
Authors: de Almeida Isabela Neves , da Silva Suely Conceição Alves , de Oliveira Junior Haliton Alves , de Assis Figueredo Lida Jouca , Soares Valéria Martins , da Silva Carvalho Wânia , Kritski Afrânio , da Silva Vater da Costa Fiori Maria Cláudia , de Miranda Silvana Spíndola
Published: February 2024

Background:

Drug-resistant tuberculosis (TB) is an ongoing health threat, and the greatest challenge to adequate control of TB in many countries lies in the lack of proper laboratory drug-susceptibility test. The aim of this study was to evaluate the activity-based costs (ABC) of Kit SIRE Nitratase® (Kit SIRE) and compare its values with the conventional drug-susceptibility test.

Methods:

The ABC was calculated for three different approaches: Kit SIRE (clinical samples and cultures), proportion methods in Lowenstein Jensen (PM-LJ), and the Bactec™ MGIT™ 960 system based on Mycobacterial Research Laboratory's routine.

Results:

The ABC of Kit SIRE from cultures was US$ 148.54, while from clinical samples was US$ 136.12. In the case of conventional tests, the ABC of Bactec™ MGIT™ 960 was US$ 227.63 and of the PM-LJ was US$ 132.64. The Kit SIRE has a lower ABC when clinical samples are used instead of cultures. Compared to conventional tests, the ABC is similar to the PM-LJ and lower the Bactec™ MGIT™ 960.

Conclusion:

The Kit SIRE should be used as a screening method in clinical specimens and in culture for laboratories that do not have Bactec™ MGIT™ 960. Therefore, it can be incorporated into the routine of laboratories in countries with low resources and a high burden of TB and drug-resistant TB.
Primary invasive squamous cell carcinoma of the nipple in an adult male: A case report and brief review of literature
Authors: Jain Priyansh , Acharya Prapti , Sultania Mahesh , Muduly Dillip K. , Sable Mukund N.
Published: February 2024

This is a case report of a rare and uncommon primary invasive squamous cell carcinoma (SCC) of the nipple in a male patient. The patient presented with an ulcerated growth over the left nipple for the last 20 years, which progressed over the last 6 months. He underwent wide local excision with level II axillary lymph node dissection, and one out of 42 lymph nodes harvested showed metastatic deposit. The patient was planned for follow-up with no adjuvant treatment, and had no evidence of local-regional or distant recurrence at 24 months follow-up. The primary invasive SCC of male nipple is very rare, and its diagnosis is challenging as it can be confused with other clinical conditions. However, a histopathological examination with immunohistochemistry can differentiate primary SCC nipple from other differential diagnoses. The treatment options for cutaneous SCC include surgical excision, cryotherapy, electrosurgery, topical ointments, definitive radiation therapy, and photodynamic therapy. Regional lymph node dissection in SCC nipple could potentially have therapeutic and prognostic significance.
Sirka: An alternative to the formalin fixative
Authors: Gotur Suhasini P. , Kamarthi Nagaraju , Wadhwan Vijay
Published: February 2024

Formalin fixation is the most essential step of routine histopathology practice. During the last few years, various fixatives have been developed for use in histopathology practice as an alternative to formalin, to overcome its side effects on health. Here we have demonstrated an interesting and novel idea of using sirka or sugar cane vinegar as an alternative to the formalin with the adequate result.
“At-Job” Exercise Program versus Ergonomic Brochure on Pain and Disability in Preprimary School Teachers with Low Back Pain
Authors: Agre Sharayu , Agrawal Ronika
Published: February 2024

Context:

The incidence and prevalence of work-related low back pain (LBP) in preprimary teachers are high due to job profile. Interventions that will address this multifaceted problem are strength training, mobility, and preventive measures. These interventions should be admissible during work. Hence, the objective of this study was to compare the effect of “At-Job” exercises and ergonomic brochures on pain and disability in preprimary school teachers suffering from LBP, since both can be administered at work.

Subjects and Methods:

An interventional study was conducted in schools of Pune on 120 preprimary school teachers with mechanical LBP. The participants were allocated randomly to the Group A “At-Job” exercise group and the Group B ergonomic brochure group. The intervention was given for 6 weeks. Outcome measures Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were recorded at the beginning and the end of the intervention.

Results:

Both “At-Job” exercises and ergonomic groups demonstrated statistically significant reductions in the VAS and ODI scores (P < 0.05). When a comparison was done between the groups, Group A (“At-Job” exercise) was significantly better than Group B in terms of the VAS as well as ODI (P < 0.05).

Conclusion:

Although both the “At-Job” exercise and ergonomic brochure groups were effective in reducing chronic LBP, the “At-Job” exercise group showed better improvement than the ergonomic brochure intervention.
Evaluation of Respiratory Muscle Strength in Patients with Heart Failure
Authors: Nambiar Veena Kiran , Nagamallesh U. M. , Pitambare M.
Published: February 2024

Context:

The estimated prevalence of heart failure (HF) is around 1% of the total population in India which is close by to 8–10 million individuals. Due to metabolic and structural skeletal muscle dysfunctions, peripheral muscles are impaired in the early stages of chronic HF (CHF). In experiments on rats with CHF, biopsies of respiratory muscles revealed histological abnormalities, such as atrophy of type 1 diaphragm fibers, resulting in decreased respiratory muscle strength and endurance.

Aim:

To determine the strength of respiratory muscle and pulmonary function in individuals having Class II and Class III HF.

Settings and Design:

Descriptive, observational, case–control study design.

Subjects and Methods:

Subjects included 37 HF patients having Class II and Class III in one group and controls in another group. The respiratory muscle strength (maximal inspiratory pressure [MIP] and maximal expiratory pressure [MEP]) was evaluated using respiratory pressure meter (RPM) and pulmonary function (forced expiratory volume at the end of 1 s [FEV1] and forced-vital capacity [FVC]) assessment using spirometry-Schiller (micro RPM).

Statistical Analysis Used:

Median and IQR were used to describe the study variables MIP, MEP, FVC, and FEV1, and the Mann-Whitney U test to compare the study variables between the two groups.

Results:

The outcomes were interpreted as the median values. The MIP and MEP were 59 and 70 cmH2O, respectively, in HF as compared to 97 and 96 cmH2O in the control group, significant at P < 0.001. The FEV1 and FVC in HF were 114 and 88% sequentially as compared to 130 and 99% in the control group, significant at P < 0.05.

Conclusions:

The respiratory muscle strength and pulmonary functions are impaired in individuals having Class II and Class III HF.
Prevalence of Pelvic Girdle Pain in Pregnancy: A Narrative Review
Authors: Mathew Nice , Nambiar Veena Kiran , Jyothi GS
Published: February 2024

Pregnancy is an exciting, unique, and usually one of the happiest moments in a woman’s life. It highlights the woman’s amazing creative and nurturing powers while providing a bridge to the future. It is a state of having implanted products of conception located in the uterus. Database search was conducted, using the MeSH terms “Pelvic girdle pain,” “prevalence,” “trimester,” and “pregnancy” for relevant peer-reviewed articles. Google Scholar, Science Direct (Elsevier), Scopus, CINAHL, Cochrane Library (Wiley), Healthcare Journals, Medline/PubMed, and Google were the areas of the database search. Out of 817 articles, ineligible studies were excluded after initial manual title and abstract screening. Only 55 studies which were full articles were retrieved. Of them, 19 fulfilled the inclusion criteria and were included in the review. The prevalence rates varied from 4% to 76% globally based on the country and ethnicity. The causes and concerns leading to pelvic girdle pain (PGP) were described. The complications pertaining to PGP in pregnancy were stated. When compared globally we could retrieve only one Indian study which directs our attention toward need for documentation and publishing of Indian findings. PGP in pregnancy is found to be a universal and disabling issue that needs to be addressed.
Effectiveness of Peabody Developmental Motor Scale-2 as an Outcome Measure: A Systematic Review
Authors: Deshpande Vinuta , Metgud Deepa , Gadre Mrunmayi , Kale Shriya
Published: February 2024

This review aimed to assess the utility of the Peabody Developmental Motor Scale-2 (PDMS-2) as an outcome measure for evaluating the motor performance of children. A comprehensive search strategy was employed, utilizing Google Scholar, PubMed, and PEDro databases from 2010 to April 2021, focusing on studies incorporating PDMS-2 in pediatric physical therapy. Text words and medical subject headings terms guided the search process. Nineteen selected studies underwent evaluation using the PEDro checklist, where scores ranged from 0 to 10. Scores of 0–3 were deemed poor, 4–5 fair, 6–8 good, and 9–10 excellent. Results revealed varying levels of methodological quality among the studies: 3 scored fair (5/10), 3 scored good (6/10), and 8 achieved a good rating (8/10). Furthermore, 4 studies received a high rating (9/10), while 1 study attained an excellent score (10/10). These scores reflected the internal and structural validity of the individual studies. The synthesis of findings suggests that PDMS-2 emerges as a reliable and valid assessment tool for measuring motor proficiency in children. Notably, the test’s ease of administration further enhances its broad feasibility. In conclusion, PDMS-2 proves to be an efficient outcome measure, exhibiting potential for evaluating improvements in motor skills and overall developmental progress in children.
Effect of Craniocervical Flexor Training on Pain, Strength, and Quality of Life in Subjects with Chronic Neck Pain
Authors: Gorajiya Khushboo Singh , Nagaraj Sibbala
Published: February 2024

Background:

In context, neck pain is the most prevalent musculoskeletal complaint. Common causes of neck pain include poor posture at work, nervousness, stress, strain, carrying heavy objects, and strenuous physical activity. To enhance a patient’s functional status and quality of life (QOL), knowledge of the structures that can cause pain impairment is essential. It was found that a craniocervical flexor training course provides an improved method of isolating the deep cervical flexors.

Objective:

The purpose of this training was to assess the effectiveness of craniocervical flexion training in reducing pain, increasing strength, and enhancing well-being in those with persisting neck pain.

Methodology:

Two sets of 20 subjects were used in this study. The treatment (craniocervical flexion training) was administered 5 days a week for 4 weeks. Pain was evaluated using a Visual Analog Scale (VAS), strength was assessed using the craniocervical flexor test, and QOL was measured with the short form 36 before and after treatment.

Results:

Both groups improved their strength and QOL from pretreatment levels, and the VAS scores of both groups decreased from pretreatment levels. In contrast, both pain and QOL improved more in Group A.

Conclusion:

This study concludes that, when it comes to managing chronic neck pain, craniocervical flexion exercise is more effective than isometric exercise, scapulothoracic exercise, and transcutaneous electrical nerve stimulation alone.
The Impact of COVID-19 on the Mental Health and Musculoskeletal Pain in Post-COVID-19-Recovered Patients
Authors: Raghav Deepak , Singh Nishant
Published: February 2024

Background:

The COVID-19 pandemic is having worldwide impact including mental and physical health. The objective of this study is to evaluate the mental health and musculoskeletal pain in postrecovered patients.

Methods:

A 4-week exercise program including warm-up exercises, strengthening exercises, relaxation exercises, deep breathing exercises, and cool down exercises was designed for this interventional study. A total of 100 corona-recovered patients were selected from the physiotherapy department of the hospital. All the patients were instructed to come to the department for postassessment and then the data were analyzed.

Results:

The significant results were seen in the following variables on the basis of comparison between week 1 and week 4: Visual Analog Scale score (week 1: 2.11 ± 1.77 and week 4: 0.79 ± 1.21), modified Borg Dyspnea Scale (week 1: 2.07 ± 1.65 and week 4: 0.79 ± 1.21), Warwick–Edinburgh Mental Well-being Scale (week 1: 42.5 ± 4.6 and week 4: 59.4 ± 6.7), and Cornell Musculoskeletal Discomfort Scale (week 1: 8.32 ± 6.1 and week 4: 1.68 ± 2.42).

Conclusions:

The study concluded that there was significant reduction of physical and mental health status of patients with history of COVID-19.