bluuebunny/crossref_metadata_2025 huggingface dataset:
Fragilité, vulnérabilité et ressorts de santé des personnes âgées
Authors: Michel Hervé , Koster Raphaël , Duclos Alexandre , Béland François , Duchêne Jacques
Published: June 2022

À partir d’observations socio-ethnographiques à domicile, cet article explore les conditions d’application des notions de fragilité, vulnérabilité et atouts / ressorts de santé au repérage, au suivi et à la prévention de la perte d’autonomie des personnes âgées. Relevant d’univers différents, ces trois notions offrent des cadres d’analyse et d’intervention complémentaires.La notion de fragilité, dans son acception gériatrique, appartient à l’univers de la maladie ; elle se présente comme une diminution plus ou moins étendue des réserves physiologiques qu’un individu mobilise face à un stress. Les atouts / ressorts de santé se situent d’emblée dans le domaine de la santé, conçue non pas comme un problème à résoudre mais comme une ressource à promouvoir. Les atouts / ressorts de santé reposent sur les activités et relations qui forment le fil directeur de la vie des personnes âgées, les modes d’accompagnement de leur entourage et la qualité des environnements. La vulnérabilité, concept probabiliste qui saisit la relation ou la proximité par rapport à un danger, se rapproche de la fragilité par la notion de risque et des atouts / ressorts de santé par la notion de coping (capacité à faire face, à s’adapter). La vulnérabilité a l’avantage d’offrir une perspective plus large sur les risques associés au vieillissement, et d’entrouvrir la porte à la notion d’atouts / ressorts de santé pour commencer à caractériser les dimensions positives de la santé et de l’autonomie à domicile : en particulier les ressources mobilisées pour faire face aux risques et les motivations qui portent au quotidien les personnes âgées.
Une mise en perspective de l’analyse du SIDA dans les régions françaises
Authors: Valdes Béatrice
Published: June 2022

Jusqu’au milieu des années 1990, l’incidence du SIDA reflétait assez fidèlement l’incidence du VIH, avec un décalage dans le temps. Les différences régionales en la matière s’expliquaient par un impact variable des différents modes de transmission du VIH. En France métropolitaine, malgré la similitude des évolutions temporelles observées jusqu’au milieu des années 1990, il existe de fortes différences régionales. L’analyse de l’incidence et de la mortalité du SIDA, selon les régions françaises met en évidence des disparités infranationales. Une comparaison avec l’incidence du SIDA dans les régions suisses et espagnoles met en perspective les résultats concernant les régions françaises. La géographie du SIDA à l’échelle des régions permet notamment de révéler des effets frontières.
Les migrants subsahariens face à la précarité résidentielle et administrative à l’arrivée en France : l’enquête ANRS Parcours
Authors: Gosselin Anne , Desgrées du Loû Annabel , Pannetier Julie
Published: June 2022

Les personnes nées en Afrique subsaharienne constituent en France l’une des populations les plus touchées par l’hépatite B et par l’infection VIH. Pour ajuster les stratégies de santé publique aux besoins propres de ces migrants, il est nécessaire de mieux comprendre ce qui accroît leur vulnérabilité face à ces infections, en particulier les expériences de précarité qui peuvent accompagner l’installation en France. Si la précarité des migrants est souvent évoquée, celle-ci est en réalité relativement mal mesurée ; en particulier la fréquence des précarités et leur place dans la trajectoire individuelle sont mal connues.Afin d’étudier comment les trajectoires de santé, les trajectoires sociales, familiales, migratoires et administratives s’entrecroisent et se construisent les unes par rapport aux autres parmi les Africains vivant en France, une enquête a été menée en 2012-2013 en Île-de-France, l’enquête Parcours pour « Parcours de vie, VIH et hépatite B chez les migrants subsahariens vivant en Île-de-France ». Cette enquête biographique, réalisée dans 70 services de santé, est la première en France à utiliser la méthode de collecte biographique démographique pour des recherches dans le champ de la santé, en impliquant des professionnels de santé.Nous présentons ici la méthodologie et la collecte de l’enquête Parcours et nous discutons des leçons tirées de cette expérience d’une enquête biographique en structures de santé et auprès de migrants. Puis nous présentons comment deux types de précarité vécues en France, la précarité résidentielle et la précarité administrative, ont été caractérisées sur l’ensemble des trajectoires biographiques. Enfin nous estimons le niveau de ces précarités lors de l’arrivée en France, leur évolution au long du séjour en France et leurs déterminants.
Asilo y refugio. El legado colonial en el humanitarismo actual
Authors: Ruiz-Estramil Ivana Belén
Published: June 2022

En este artículo se analiza la huella colonial presente en la gestión humanitaria actual, atendiendo al caso concreto de asilo y refugio en Europa, trazando un devenir histórico a partir de las consideraciones plasmadas por Bartolomé de las Casas en su obra Brevísima relación de la destrucción de las Indias. Partiendo de esta obra, se analizan distintos periodos de la gestión internacional del humanitarismo, para destacar aquellos aspectos que se van modificando en su forma de actuar pero que continúan estando marcados por la visión colonial y la perpetúan. Se repara en la concepción colonial del sujeto de atención del humanitarismo, partiendo de la hipótesis de que la huella colonial en la definición y reconocimiento del “otro” vulnerable susceptible de protección actúa también hacia el interior de los Estados europeos, donde el procedimiento de asilo es un claro exponente de la construcción ética normativa que legitima una jerarquía que se impone a quien solicita asilo.
Forma cultural: construindo o conceito a partir do campo literário
Authors: Cabeça Sónia Moreira , Santos José Rodrigues dos
Published: June 2022

O campo literário é uma forma cultural, um sistema de práticas individualizado, caracterizável pelos seus atributos e pela estrutura que assume. Nele, os actores formulam discursos sobre as suas práticas, daí emergindo tanto um conjunto de normas que regulam as práticas como uma estrutura. Estrutura, normas e acção dos praticantes concorrem para dar a forma à forma. A partir dos diferentes entendimentos do que pertence (ou não) ao domínio do literário e de algumas (r)evoluções no campo, o presente artigo define os elementos duma forma cultural e dá conta da sua dinâmica que, ao longo do tempo, explica que algumas regras sejam reformuladas, surjam novos portadores e se observem determinadas reestruturações sem que a forma cultural deixe de existir enquanto tal.
A carreira de investigador em perspetiva histórica – O caso português
Authors: Castro Helena , Brandão Tiago
Published: June 2022

Neste artigo procura-se tratar o estatuto dos investigadores sob uma perspetiva histórica. Adota-se uma narrativa com que se procura resgatar a história dos investigadores em Portugal, sendo esta desde a sua origem vincada por uma forte vertente académica e dependente das oscilações do fluxo de financiamento para a Ciência e Tecnologia em Portugal. Dá-se assim a compreender a herança de um sistema científico que foi sendo constituído ao sabor das circunstâncias, muitas vezes atrelado a uma institucionalidade conservadora – incluindo tanto as universidades portuguesas como os laboratórios do Estado – favorecendo um abismo que vem mantendo os investigadores distantes tanto da sociedade civil como do meio empresarial, num panorama que acarreta perdas para todas as partes e, sobretudo, para o país como um todo.
População no sistema prisional português: evolução e tendências entre 2000 e 2017
Authors: Carvalho Maria João Leote de , Gomes Sílvia , Duarte Vera , Oliveira Raquel
Published: June 2022

Este artigo apresenta uma reflexão sobre as principais tendências identificadas na evolução da população recenseada no sistema prisional português, entre 2000 e 2017. Partindo de uma análise que cruza as alterações no campo do direito penal com os dados estatísticos oficiais e relatórios e estudos nacionais e internacionais sobre a aplicação da pena de prisão no país, pretende-se compreender e identificar alguns dos desafios colocados ao sistema pelo movimento da população prisional, assim como pelas mudanças registadas no perfil desta população. A evolução e tendências identificadas permitem indagar sobre o impacto da lei e contribuir para identificar alguns dos caminhos que falta traçar em resposta aos imperativos legais internacionais em matéria da população a cumprir pena privativa de liberdade.
Prácticas sociales de paz en Colombia: el caso de la Confluencia de Mujeres para la Acción Pública
Authors: Solano-Nivia Sandra Julie , Farfán-Pérez Nasli Giomara , Jaime-Salas Julio
Published: June 2022

Este artículo de investigación tiene como objetivo analizar las prácticas sociales de paz del proceso nacional de Confluencia de Mujeres para la Acción Pública (CMAP) de 2009-2019, como una expresión del movimiento social por la paz en Colombia. Entre las conclusiones más importantes se encuentran las siguientes: la oportunidad de identificar que las prácticas sociales de paz de la CMAP se hacen evidentes en la acción colectiva feminista, lo simbólico como potencia política y las memorias subalternas como construcciones de saber. A su vez, se reconoce el aporte del movimiento social en Colombia caracterizado por producir prácticas de paz, ya que ha sido un movimiento en defensa de la vida y de los territorios.
Comparison of efficacy of autologous blood patch pleurodesis versus doxycycline pleurodesis in the management of persistent air leak in patients with secondary spontaneous pneumothorax. A randomized controlled trial
Authors: Narenchandra Vijayarangam , Vishnukanth Govindaraj , Dwivedi Dharm Prakash , Hemachandren Munuswamy , Adithian Subathra , Vinod Kumar Saka , Rajangam Manju , Mohapatra Madhusmita Mohanty , Upadhya Pratap
Published: June 2022

Secondary spontaneous pneumothorax (SSP) patients sometimes have a persistent air leak (PAL) that leads to increased morbidity and increased hospital stay. Further, these patients also need pleurodesis to prevent a recurrence. Autologous blood patch pleurodesis (ABPP) has been successfully tried in post-lobectomy air leak cases. However, its utility in SSP patients with PAL has not been widely established. In this context, we performed a non-blinded randomized control study to compare the efficacy of ABPP vs doxycycline pleurodesis in the closure of air leak in SSP patients. This study was a non-blinded randomized control study done in 38 SSP patients with PAL. They were randomized into doxycycline arm and ABPP arm. Post pleurodesis air leak was assessed every 12 hours for cessation. Success was considered when there was a complete cessation of air leak. Post-procedural complications were noted and patients were followed up for 28 days to look for recurrence. The median time for closure was 24 hours [interquartile range (12.24)] for ABPP and 36 hours [interquartile range (24.72)] for doxycycline pleurodesis. Success rate of ABPP vs doxycycline pleurodesis is 94.7% vs 84.2% (p=0.6). Post-procedure pain was more in doxycycline group (15% vs 73%) (p<0.01). On visual analogue scale, ABPP had a lesser pain as compared to doxycycline pleurodesis (average visual analogue scale value of 2 vs scale of 7). The recurrence rate was equal in both groups (5%). Though ABPP and doxycycline have similar success rates, ABPP has an early closure of air leak and greater patient tolerability. ABPP can be tried as an alternative to doxycycline pleurodesis in SSP patients with persistent air leaks.
Usefulness of CURB-65, pneumonia severity index and MULBSTA in predicting COVID-19 mortality
Authors: Preti Carlo , Biza Roberta , Novelli Luca , Ghirardi Arianna , Conti Caterina , Galimberti Chiara , Della Bella Lorenzo , Memaj Irdi , Di Marco Fabiano , Cosentini Roberto
Published: June 2022

The aim of our study is to evaluate the accuracy of CURB-65 and Pneumonia Severity Index (PSI), the most widely used scores for community acquired pneumonia, and MuLBSTA, a viral pneumonia score, in predicting 28-day mortality in Coronavirus Disease 2019 (COVID-19) pneumonia.We retrospectively collected clinical data of consecutive patients with laboratory-confirmed COVID-19 pneumonia admitted at Papa Giovanni XXIII Hospital from February 23rd to March 14th, 2020. We calculated at Emergency Department (ED) presentation CURB-65, PSI and MuLBSTA and we compared their performances in discriminating between survivors and non-survivors at 28 days. Among 431 hospitalized patients, the majority presented with hypoxic respiratory failure: median (interquartile range, IQR) PaO2/FiO2 ratio at admission was 228.6 (142.0-278.1). In the first 24 hours, 111 (27%) patients were administered low-flow oxygen cannula, 50 (12%) Venturi Mask, 95 (23%) non-rebreather mask, 106 (26%) non-invasive ventilation, 12 (3%) mechanical ventilation and 41 (9%) were not administered oxygen therapy. Mortality rate at 28-day was 35% (150/431). Between survivors and non-survivors, median (IQR) scores were, respectively, 1.0 (1.0-2.0) and 2.0 (2.0-3.0) for CURB-65 (p<0.001); 90.5 (76.0-105.5) and 115.0 (100.0-129.0) for PSI (p<0.001); 7.0 (5.0-10.0) and 11.0 (9.0-13.0) for MuLBSTA (p<0.001). Areas under the receiver operating characteristic curve (AUCs) for each score were, respectively, 0.725 (0.662-0.787), 0.776 (0.693-0.859) and 0.743 (0.680-0.806) (p>0,05). PSI and MuLBSTA did not show a better performance when compared to CURB-65. Although CURB-65, PSI and MuLBSTA scores are useful tools to discriminate between survivors and non-survivors in COVID-19 pneumonia, their diagnostic accuracy in discriminating 28-day mortality in COVID-19 pneumonia is moderate, as confirmed by AUCs <0.80, and there is a potential underestimation of disease severity in the low-risk classes. For this reason, they should not be recommended in ED to decide between inpatient and outpatient management in patients affected by COVID-19 pneumonia.
Association of vitamin D levels and asthma exacerbations in children and adolescents: Experience from a tertiary care center
Authors: Aziz Danish Abdul , Abbas Aiza , Viquar Werdah , Munawar Hussain Ali
Published: June 2022

The role of vitamin D as an immunosuppressant and anti-inflammatory has been studied previously for different pathologies in different populations globally. Relationships between serum vitamin D levels and its effect on asthma exacerbations in the adolescent asthma population are not well studied in this region. Therefore, this study was conducted to determine the vitamin D status in pediatric and adolescent asthma patients, and its association with asthma exacerbations. A retrospective study was conducted at The Aga Khan University Hospital from 2016 to 2020. Children and adolescents who were diagnosed and admitted with acute asthma exacerbations and who had at least one measurement of 25 hydroxy-vitamin D (25 OHD) were included in the study. Serum vitamin D levels were documented for enrolled patients and their past 2-year data was analyzed for asthma exacerbations, mean length of stay per admission, and admission plus length of stay at High Dependency Unit. 114 patients were included in the study. 41 patients (35.96%) were found to be Vitamin D deficient, 38 patients (33.3%) were Vitamin D insufficient, and 35 patients (30.7%) were labeled as Vitamin D sufficient. The average number of exacerbations per year was significantly high in Vitamin D deficient group (2.82±1.11) in comparison with insufficient (2.05±0.92) and sufficient groups (1.37±0.59) (p<0.001). Vitamin D deficiency is related to an increased number of annual asthma exacerbations, length of stay per admission, and admission into High Dependency Unit (HDU).
Anomalous left coronary artery from pulmonary artery (ALCAPA) as a silent cause of mitral regurgitation in children
Authors: Ashraf Naela , Zubairi Suha , Atiq Mehnaz , Ahmed Farheen , Amanullah Muneer
Published: June 2022

Anomalous left coronary artery from pulmonary artery (ALCAPA), also known as Bland-White-Garland syndrome, is a rare cardiac disease. This condition may present with complications such as myocardial infarction, left ventricular dilatation, mitral regurgitation, and left heart failure in children. We report a case of a four-year-old boy who presented with shortness of breath, palpitations, and recurrent upper respiratory tract infections. He was diagnosed with mitral regurgitation. During the surgery, left coronary artery (LCA) was not present in its anatomical position and ALCAPA was identified. One should keep in mind the possibility of ALCAPA in presentation of mitral regurgitation in children despite not being reported in echocardiography.
Pulmonary rehabilitation: A novel adjunct in management of obstructive sleep apnea
Authors: Agarwal Prakhar , Garg Kranti , Saini Varinder , Singh Isha
Published: June 2022

Pulmonary rehabilitation (PR) is being used in the routine management of patients of obstructive sleep apnea (OSA) at some centers. However, the studies documenting benefits of PR in OSA lack standardization in terms of outcome measures. A study was hence planned to determine the efficacy of PR on exercise capacity, health related quality of life (HRQOL), day time sleepiness and sleep-quality of life (QOL) in patients of OSA. As a part of comprehensive therapy, patients diagnosed with OSA are managed with continuous positive airway pressure (CPAP), 8 weeks thrice weekly outpatient hospital-based PR and medical treatment at the Pulmonary Medicine Department, Government Medical College and Hospital, Chandigarh. However, some patients refuse for PR because of time constraints and travel issues. Patients with newly diagnosed OSA without co-existing respiratory disease, who agreed for the CPAP, PR and medical management were enrolled in group A. The patients who refused for PR but were ready for CPAP and medical management were enrolled in Group B; 30 patients were taken in each group. Exercise capacity, HRQOL, day time sleepiness and sleep-QOL were determined at baseline and at 8-weeks follow-up by 6-minute walk distance (6MWD), St. George's Respiratory Questionnaire (SGRQ), Epworth Sleepiness Scale (ESS) and Functional Outcomes of Sleep Questionnaire (FOSQ) and compared amongst the two groups. Four patients from group A were excluded as they did not complete PR; 26 patients from group A and 30 patients from group B were finally analyzed. At baseline, both groups were matched with respect to age, gender, apnea-hypopnea index (AHI), body mass index (BMI), FEV1%predicted, 6MWD, SGRQ, ESS and FOSQ. At follow up at 8 weeks, BMI, 6MWD, SGRQ, ESS and FOSQ improved significantly from baseline in group A (p<0.001). FEV1%predicted also improved but non significantly. In group B, FEV1%predicted, BMI, 6MWD, SGRQ, ESS and FOSQ score did not improve significantly from baseline. Mean improvement from baseline in BMI, 6MWD, SGRQ, ESS and FOSQ was significantly more in group A than group B (p<0.001, p<0.001, p=0.041, p<0.001 and p<0.001, respectively). PR, being beneficial, should be incorporated in standard management of OSA.
Cardiac biomarkers and mortality in COVID-19 infection: A review
Authors: Cersosimo Angelica , Cimino Giuliana , Amore Ludovica , Calvi Emiliano , Pascariello Greta , Inciardi Riccardo Maria , Lombardi Carlo Mario , Vizzardi Enrico , Metra Marco
Published: June 2022

Lots of meta-analysis emphasize that a great number of hospitalized patients with moderate and severe forms of COVID-19 developed acute myocardial damage, defined as an increase of cardiac biomarkers, such N-terminal pro–B-type natriuretic peptide (NT-pro-BNP), creatine kinase-myocardial band (CK-MB) and of all type of troponins. The highest mortality rate is related with progressively increasing biomarkers levels and with a history of cardiovascular disease. In fact, the biomarkers dosage should be considered as a prognostic marker in all patients with COVID-19 disease at admission, during hospitalization and in the case of clinical deterioration. The purpose of this review is to evaluate cardiovascular prognostic factors in COVID-19 disease throughout the analysis of cardiac biomarkers to early identify the most serious patients and to optimize their outcomes.
Unusual lymphadenopathy diagnosed by endobronchial ultrasound-guided transbronchial needle aspiration
Authors: Stirpe Emanuele , Bardaro Floriana , Köhl Johanna
Published: June 2022

Oxidized cellulose, used as hemostatic in thoracic surgery, may cause in some cases foreign body reactions, and simulate other diseases. We report the case of a 39-year-old man operated on a middle lobe lobectomy for atypical carcinoid. The follow up chest-CT showed enlarged mediastinal lymph nodes, so endobronchial ultrasound-guided transbronchial needle aspiration was performed suspecting recurrence of the tumor. The cytology results showed amorphous fragments such as foreign body reaction secondary to Pahacel®, used as hemostatic during the surgery. A few days later, the patient was re-operated on suspicion of mediastinitis induced by the endoscopic procedure. The aim of this case is to consider the foreign body reaction to Pahacel®, in patients with postoperative thoracic lymphadenopathy. It is also important to remember that in these patients the endoscopic procedures allow the diagnosis but may cause mediastinitis.
Pattern of Childhood Injury in a Tertiary Centre
Authors: Aderibigbe Rotimi O. , Ogunrewo Tolulope O.
Published: June 2022

Introduction:

Childhood injury and death have been projected to be a disease of public health significance, however, the trend in many developing countries of which Nigeria is one is still unknown. We, therefore, examine the pattern of childhood traumatic injury in our institution.

Materials and Methods:

The information of patients aged 16 years and below who presented with trauma was extracted from the trauma registry of the emergency units of University College Hospital, Ibadan, from 2015 to 2020. Data were analysed using the SPSS version 20.

Results:

A total of 3146 children were managed for trauma in the accident and emergency departments of the hospital. Most of them were males (61.2%) and within the under-five age group (36.4%). The majority of the injuries were secondary to fall (41.8%). Male child was more likely to be involved in any mechanism of injury and children between 11 and 16 years were commonly involved in machine hand injury (80%). Following intervention in the accident and emergency department, 44.1% were discharged in the emergency units, 21.5% required admission into the specialist ward, 6.0% died, 5.0% discharged against medical advice and 2.6% were referred.

Conclusion:

The burden of childhood injury is becoming significant thus demands more attention.
Comparison of Clinical Outcome and Anal Manometry following Laparoscopic-assisted Anorectoplasty and Posterior Sagittal Anorectoplasty in Patients with High and Intermediate Anorectal Malformation
Authors: Gupta Chhabi Ranu , Bhoy Tejal , Mohta Anup , Sengar Mamta , Khan Niyaz A. , Manchanda Vivek , Kumar Parveen
Published: June 2022

Introduction:

High and intermediate types of anorectal malformations (ARMs) may be managed by either open posterior sagittal anorectoplasty (PSARP) or by laparoscopic-assisted anorectoplasty (LAARP). Most of the literature favours one approach over the other based on retrospective analysis. We performed this study with the aim to compare the short-term outcomes of both procedures.

Materials and Methods:

All paediatric patients with high and intermediate ARM were enrolled and randomised into two groups: open PSARP group and LAARP group. Outcome parameters such as faecal continence using Kelly's scoring system, anal manometric parameters and post-operative complications were compared between the groups.

Results:

A total of 16 patients were included with equal distribution in the open PSARP and LAARP group. Patient's variables were comparable in both the groups. Five patients developed immediate post-operative complications, three in the LAARP and two in the open group. The mean Kelly's score was 3.63 ± 1.6 versus 2.57 ± 1.9 (P = 0.132) for LAARP and PSARP group, respectively. The mean resting pressure was 34.71 ± 6.26 cm of H2O and 35 ± 6.16 cm of H2O (P = 0.384) in LAARP and open group, respectively. Rectoanal inhibitory reflex was demonstrated in 6/7 patients in LAARP group and 5/7 patients in open group.

Conclusion:

Faecal continence in patients undergoing either of the procedure is comparable. However, wound-related complications are lesser in LAARP procedure.
Steri-Strip™ versus Subcuticular Skin Closure of Paediatric Groin Wounds
Authors: Ladipo-Ajayi Oluwaseun Abiola , Lawal Taiwo Akeem , Ogundoyin Olukayode O. , Michael Afieharo Igbibia
Published: June 2022

Background:

A technique that offers the best chance of an optimal result is most appropriate to be employed for wound closure.

Aims:

We set out to compare the cosmetic outcome, and wound complication rates associated with clean paediatric groin wounds closed using Steri-Strip™ or subcuticular suturing.

Settings and Design:

A prospective randomised study.

Subjects and Methods:

Children of African descent with unilateral and bilateral clean groin wounds were randomised into subcuticular suture skin closure and Steri-Strip™ groups and followed up postoperatively. Cosmetic assessment and outcome were scored based on parents' satisfaction using the visual analogue scale (VAS) and a single Plastic Surgeon assessed pictures of the scars using the Hollander Wound Evaluation Scale (HWES). Statistical analysis was used SPSS version 18.

Results:

Seventy-five wounds were assessed, (n = 35, Steri-Strips™) and (n = 40, suturing). Closure with Steri-Strips resulted in scars with comparable cosmesis as those with subcuticular suturing. Wound complications were also similar. There was no statistically significant difference between mean VAS scores on the 5th day (P = 0.320), 2nd week (P = 0.080), 4th week (P = 0.070) and 8th week (P = 0.080). The HWES scores were also comparable at those times.

Conclusions:

We conclude that skin closure of clean paediatric groin wounds with SteriStrips™ gives comparative cosmetic outcomes with subcuticular suturing.
Experience with the use of Mohan's Valvotome for Posterior Urethral Valve Ablation at a Centre in North-Eastern Nigeria
Authors: Oyinloye Adewale Olaotan , Abubakar Auwal Mohammed , Wabada Samuel , Rikin Christopher Uruku
Published: June 2022

Introduction:

Posterior urethral valve (PUV) is the most common congenital cause of lower urinary tract obstruction in boys. Management has remained challenging in our region, with features of renal impairment evident in some patients at the time of presentation. Endoscopic valve ablation is the gold standard of treatment, but this is not readily available in our setting. Mohan's valvotome has been described as an alternative device for valve ablation. This study aimed to highlight the clinical presentation, management and early outcomes following valve ablation using Mohan's valvotome.

Methods:

A retrospective study of boys with PUVs managed between September 2014 and June 2018 was done. The demographic characteristics, clinical features, investigations, treatment and initial outcomes were reviewed. The main outcome measures were improved post-ablation urinary stream, serial serum creatinine values at presentation, 4–5 days of initial catheter drainage and at follow-up.

Results:

There were ten boys with the median age at presentation of 4 months (mean: 23.9 months; range 10 days to 7 years). Four patients presented after 1 year. All the patients had features of bladder outlet obstruction with associated fever in seven patients and urinary tract infections in six patients. Nine patients (90%) had suprapubic masses, while 2 had ballotable kidneys with co-existing urinary ascites in one patient. Valve ablation was achieved with Mohan's valvotome. There was a significant improvement in the urine stream in all patients. The median duration of follow-up was 7.5 months. Median serum creatinine was 0.95 mg/dl (mean 0.94 mg/d ± 0.38 mg/dl) at follow-up, compared to a median of 4.03 mg/dl at presentation (P = 0.01).

Conclusion:

Initial drainage and definitive valve ablation with Mohan's valvotome is associated with improved serum creatinine and urinary stream.
The Role of Laparoscopy in Non-palpable Undescended Testicle
Authors: Salah Sami Eldirdiri Elgaili , Ahmed Elssayed Osman Elssayed
Published: June 2022

Introduction:

It is estimated that 1%–2% of male infants have undescended testicles. The reliability of ultrasound (US) to identify the non-palpable undescended testicles (NPUDT) is controversial. Laparoscopy remains the gold standard to diagnose and manage NPUDT.

Objective:

The objective is to highlight the role of laparoscopy in the management of NPUDT in 2 cities from Sudan over the past decade.

Materials and Methods:

Patients presented to Gadarif Teaching Hospital and Almak Nimir University Hospital with NPUDT were assessed by clinical examination and US. The testis, when found during laparoscopy, was either brought down to the scrotum in a single or two-stage or removed depending on the findings. Data were collected and analysed.

Results:

Patients covered the age range between 18 months and 65 years. The average was 12.4. The majority, 94 (67.2%) patients were older than 5 years. The main presenting symptom was either bilateral or unilateral empty scrotum. In 12 (8.4%) patients, the main presenting symptom was primary infertility. US was done in 120 (86.6%) of the patients and failed to see the testis in more than half of them. A single-stage procedure in the form of laparoscopic search assisted with orchidopexy was achieved in 90 (62.9%) patients and orchiectomy in 13 (9.1%) patients, while in 12 (8.4%) patients the testis was not found. Other procedures were applied on the 28 (19.6%) patients who needed staged operation in the form of Fowler Stephen's, in bilateral cases, in 6 (4.2%) patients. Shehata's operation in nine patients (64%) and open orchidopexy for 8 (5.6%) patients. The post-operative complication was encountered in 14 (9.8%) of the patients in this group in the form of bleeding, vassal injury and testicular atrophy.

Conclusion:

Laparoscopy provides the most accurate interventional option for managing patients with NPUDT. Laparoscopic orchidopexy, whether single stage for low or 2-stages for high intra-abdominal testis, is a proven and effective extension of lap-search with minimal complications.
Alternate Management of an Anterior Maxillary Dentigerous Cyst in a Paediatric Patient
Authors: Philip Lida , D'Silva Joel , Martis Elvita , Malathi Selva
Published: June 2022

The purpose of this article is to show alternate management of an anterior maxillary dentigerous cyst in a paediatric patient. An 8-year-old male child reported to the Department of Oral and Maxillofacial surgery with the chief complaint of swelling in the upper left side of the face for 2 months. Based on the clinical and radiological findings of cystic cavity along with impacted tooth, lesion was diagnosed as dentigerous cyst and surgical enucleation was planned under general anaesthesia. Dentigerous cysts mostly occur in the mandible and are prevalent between the second to fourth decades of life. The incidence of this cyst in children is less. We present here a case report of a paediatric patient with a rare occurrence of a large cyst in the maxillary anterior region, and the treatment outcome by surgical enucleation and preservation of the permanent tooth bud are discussed. The line of treatment for dentigerous cyst is enucleation and extraction of involved tooth. We recommend the alternative treatment option, which involves enucleation of cyst, and consider the conservation of the affected tooth bud in the view of making its eruption viable in future.
Telecollaboration
Authors: Vilanilam George Chandy , Abraham Mathew , Radhakrishnan Ashalatha , Keni Ravish R. , Senanayake Sunethra , Attanayake Deepal , Muhammed Rumi Jalal Uddin , Sai Kiran N. A. , Varma Ravi Gopal , Chowdhury Forhad Hossain , Menon Ramshekhar , Thomas Bejoy , Venkat Easwer Hariharan
Published: June 2022

Background and Aim:

Although 80% of people with epilepsy live in low and lower-middle-income countries (LMIC), epilepsy surgery (ES) has reached very few of its potential beneficiaries in these nations. This imbalance could be overcome by telecollaboration ES, aided by the burgeoning digital penetration in LMIC. We aimed to propose a telecollaboration-mentorship model for resource-limited LMIC environs to initiate, sustain, and expand ES centers. We also aimed to assess the model's feasibility and provide a proof of concept.

Materials and Methods:

Five mentee centers (level 3 epilepsy centers) across three LMIC under the mentorship of a tertiary comprehensive epilepsy care center (level 4) were part of the telecollaboration-mentorship model. This model was used for surgical candidacy selection, intraoperative surgical support, and postoperative outcome assessment at the mentee centers, using both asynchronous and synchronous telecollaboration exchanges.

Results:

Nineteen patients across five centers and three LMIC underwent ES as part of the telecollaboration-mentorship program from 2018 to 2021. Sixty-eight telemedicine exchanges (average 3.5/patient), 42 asynchronous (email, text message, multimedia message), and 26 synchronous (phone call, video call, video conference) were made in the preoperative, intraoperative, and postoperative period. Worthwhile seizure outcome (Engel Class I, II) was achieved in 17 patients (89.4%) at a mean duration of follow-up of 13.5 months (standard deviation 10.9).

Conclusion:

The telecollaboration-mentorship model is a feasible, sustainable scalable, and replicable mechanism to expand the outreach of surgical care in epilepsy, especially in resource-constrained LMIC environs. It holds the potential to overcome the “ES divide” between LMIC and high-income countries and reduce the surgical treatment gap with acceptable surgical outcomes.
Square-stepping Exercises versus Conventional Exercises on Cognition and Risk of Fall in Postmenopausal Women
Authors: Desai R Roopa , Rathi Nikita Sunil , Palekar Tushar J
Published: June 2022

Background and Aim:

Menopause is the cessation of menstruation resulting from the loss of ovarian follicular activity. During menopause, there is a loss of estrogen which diminishes protective reflexes, increment bone resorption, thus speeding up bone loss. This has been seen as significant factor for decline in postural balance. Functional imaging shows that estrogen also regulates neural movement during the execution of intellectual assignments. Thus, women attaining menopause complain of issues with memory. The aim of this study was to compare square-stepping exercises (SSEs) and conventional physiotherapy training on cognition and risk of fall.

Materials and Methods:

Thirty-five postmenopausal women, attained >5 years of menopause up to 65 years of age were included in the study and were randomly allocated into SSEs Group A (n = 18) and conventional physiotherapy training Group B (n = 17). Cognition was assessed by the Montreal Cognitive Assessment and balance was assessed by the Berg's Balance Scale at pre, post-2 weeks, and post-4 weeks of intervention.

Results:

Paired t-test and unpaired t-test were used for within and between-group analysis for Berg's Balance Scale. Wilcoxon test was used for within-group analysis and Mann–Whitney test was used for between-group analysis for Montreal Cognitive Assessment. The level of significance was determined by P < 0.05 at 95% confidence interval. Statistically significant improvements were seen in both groups (P < 0.05), whereas between-group analysis, there was no significant difference with P > 0.05.

Conclusion:

Both types of exercise protocol were equally effective in improving cognition and preventing the risk of fall in postmenopausal women.
Prevalence and Risk Factors Associated with the Development of Severe Pelvic Organ Prolapse in the University of Maiduguri Teaching Hospital, Nigeria
Authors: Geidam Ado Danazumi , Goje Danladi Joseph
Published: June 2022

Background and Aim:

Pelvic organ prolapse (POP) is a common gynecological disorder that negatively affects women's quality of life, especially if it is severe. Its burden has increased because of increased in life expectancy. The aim of this study is to determine the prevalence, risk factors, and the factors associated with the development of severe POP in our environment.

Materials and Methods:

A retrospective review of cases of POP managed at the University of Maiduguri Teaching Hospital, Maiduguri, Borno State, Nigeria, over 10 years (January 2010–December 2019). Information including sociodemographic and risk factors were obtained from the gynecological ward register, case files, and theater records using a pro forma designed for the study. Data analysis was done using the Statistical Package for the Social Sciences. Multinomial regression analysis was used to determine factors that are independently associated with severe POP.

Results:

The prevalence of POP is 1.8%. The majority of the patients, 73% (54/74) were grand multipara and 64.9% (48/74) were postmenopausal. Home delivery 83.8% (62/74) and difficult labor 73.0% (54/74) were found to be the common risk factors. In 41.9% (31/74) of the cases, the POP was severe. Multivariate analysis showed postmenopausal status OR 10.7 (95% CI 1.39–82.56, P = 0.023), heavy lifting OR 13.7 (95% CI 1.73–108.75, P = 0.013), age ≥50 years OR 22.4 (95% CI 1.26–397.08, P = 0.034), and being unmarried OR 16.2 (95% CI 2.22–118.64, P = 0.006) to be independently associated with severe POP.

Conclusion:

POP is not uncommon in our environment with about half of the patients having severe disease. Postmenopausal status, heavy lifting, age ≥50 years, and being unmarried were independently associated with severe POP.
Knowledge, Beliefs, Barriers, Acceptance, and Encouragement Cues associated with COVID-19 Vaccination among Health-care Workers in India
Authors: Mudgal Varchasvi , Niranjan Vijay , Rastogi Pali , Jain Priyash
Published: June 2022

Background and Aim:

The coronavirus disease 2019 (COVID-19) is a viral pandemic that has infected millions of people that has caused the loss of human lives on an unprecedented scale. India being the second-most populous country in the world has been severely impacted by COVID-19. India began its vaccination drive on 16th January 2021 with a huge burden of 1.3 billion people to be vaccinated. Various factors play their role to predict the success or failure of a vaccination drive. The study was aimed to assess knowledge, belief, barriers, and acceptance of the COVID-19 vaccine among healthcare workers of a tertiary care centre.

Materials and Methods:

This cross-sectional study was done on healthcare workers (HCW) in February 2021. 120 HCWs participated in the study after providing their consent. Data were collected using a semi-structured proforma which included basic sociodemographic details, a questionnaire about acceptance, knowledge, beliefs, and barriers against the COVID-19 vaccine.

Results:

The mean age of the sample was found to be 36.5 years. Average knowledge, calculated by assessing the mean responses to all the questions pertaining to knowledge, was found to be 78%, while an average of 73.5% had positive beliefs regarding the vaccine for COVID-19. Concern over side effects and doubts over vaccine efficacy turned out to be the greatest barriers contributing to vaccine hesitancy. Acceptance rates of 87.4% were obtained across all the samples.

Conclusion:

Physician recommendation, acceptance by peers or family, and more studies to prove vaccine efficacy was widely acceptable cues to encourage vaccination. The study with its key findings could be a helpful aid in policymaking to boost India's vaccination drive.
Endometrial Clear Cell Carcinoma with Leiomyoma and Adenomyosis in a Postmenopausal Lady - A Case Report with Review
Authors: Mohanty Pranita , Hota Anima , Mohapatra Ajit S. , Govardhan T.
Published: June 2022

Endometrial cancer (EC) is the 6th most common cancer in women and endometrial clear cell carcinoma (CCC) comprised 2% of it. The association of uterine leiomyoma (UL) and adenomyosis (AM) with endometrioid variant of EC is well established, especially in postmenopausal women. Although the pathogenesis is still debatable, their presence with CCC is extremely uncommon. Moreover, the relation between CCC, AM, and UL is not yet validated because of limited data. Here, we report such a case of CCA associated with leiomyoma and AM in a 58-year-old postmenopausal Indian woman who presented with complaints of vaginal bleeding and watery discharge. She underwent hysterectomy and histopathology revealed CCC with multiple ULs and foci of AM, but there was no evidence of tumor transitioning from adenomyotic foci. This case study was aimed to evaluate if there really exists any clinicopathological correlation, tumor progression, and prognostic significance or simply this was a coexistence of all three entities.
Contracting Infection among Registered Nurses Working in Coronavirus Disease Units
Authors: Verma Seema , Venkateshan Mahalingam , Shetty Asha P.
Published: June 2022

Background and Aim:

Nurses are the backbone of any health system, providing quality care to the patients in the Coronavirus disease-2019 (COVID-19) pandemic. They are working as frontline warriors in this pandemic and giving their services in such challenging and difficult situations. Since nurses have high rates of exposure they are at risk of getting the SARS CoV-2 infection. The aim of the study is to explore the contributing factors for (COVID-19) infection among nurses working in COVID-2019 units.

Background:

Nurses are the backbone of any health system, providing quality care to the patients in this COVID pandemic. They are working as a frontline warrior in this COVID-19 pandemic and giving their services in such difficult situations. Nurses have direct patient contact which makes them at risk of getting an infection.

Materials and Methods:

A qualitative case series design was carried out using conventional thematic analysis through an inductive approach to explore the factors. Fourteen nurses who have turned COVID-19 positive within 7 days of their last working exposure to COVID units were interviewed using the maximum variation purposive sampling technique. Consolidated Criteria for Reporting Qualitative Research guidelines were used to report the study.

Results:

Nurses reported prolonged exposure to COVID-19 patients; challenges in the patient care environment, biological disequilibrium, and exposure to a non-COVID zone were the major factors contributing factors.

Conclusion:

It is necessary to make policies on regulating the adequate manpower (both number and gender adequacy) in various COVID units, training of every nurse, rotation of COVID duties among various teams, regular health checkups of nurses, and smart monitoring of COVID units.
Alveolar Soft Part Sarcoma
Authors: Asotra Sarita , Sharma Ankita , Vijayamohanan Lexmi
Published: June 2022

Alveolar soft part sarcoma (ASPS) is an extremely rare sarcoma. It is a malignant soft tissue tumor that arises in the muscles, commonly seen in the age group between 15 and 35 years of age with slight increased predilection in young women. Clinically, it presents as a painless, slow-growing lesion principally around the lower limb or limb–girdle with a propensity for recurrence and metastasis. Clinically, it can be confused with a hemangioma or arteriovenous malformations. We report a case of ASPS in a 36-year-old female with pain and swelling over the anterior aspect of the right thigh without any features of metastasis, who has been treated with excision of the symptomatic lesion followed by chemotherapy.
Cribriform Hyperplasia of Epididymis
Authors: Ravindra Savithri , Manjula C. P.
Published: June 2022

Epididymal tubules are lined by tall columnar ciliated cells with central round lumina. Epididymis exhibits wide variations in histology, having very little clinical significance. However, they pose a diagnostic challenge for the reporting pathologists. Cribriform hyperplasia of the epididymis is reported in animals such as rats, cats, dogs, mice, and bulls, in addition to men. We report an incidental finding of cribriform hyperplasia of the epididymis in a specimen of torsion testis.
A Case of Isolated Wide Pulp Chambers in Second Premolars along with Enamel Hypoplasia - Dentinogenesis Imperfecta - A Diagnostic Dilemma
Authors: Desai Vela D.
Published: June 2022

Dentinogenesis Imperfecta is a rare hereditary dentin developmental disorder that affects both primary and permanent dentition. It is characterized by discolored and translucent teeth ranging from gray to brownish-blue/amber. The enamel may split readily from the dentin when subjected to occlusal stress. Radiographically, there is evidence of cervical construction, short root, and pulp chambers, whereas the root canals are smaller than normal or completely obliterated. Here, the author presents the case of a 28-year-old male with generalized enamel hypoplasia and isolated distinctly translucent second premolars in three quadrants along with root changes. Unlike the classical representation of generalized involvement of the teeth, this case differs and needs to be documented. A thorough history, careful clinical, and radiographic observation are the key to early diagnosis and management of such a rare entity.
Gestational Diabetes Mellitus and Preeclampsia
Authors: Padayachee Sayuri , Govender Nalini , Naicker Thajasvarie
Published: June 2022

Both gestational diabetes and preeclampsia (PE) are characterized by anti-angiogenic response, endothelial injury, and dysfunction of the maternal vasculature. The ensuing high blood pressure emanates from a renin-angiotensin-system imbalance. The angiotensin-converting enzyme 2 (ACE2) receptor has been implicated in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) entry, and emerging data are in favor of PE development in pregnant women with COVID-19 infection. This review examines the effects of SARS-CoV-2 infection in pregnant women with gestational diabetes mellitus and/or preeclampsia (PE). An online search of all published literature was done through PubMed, Google Scholar, Medline complete, The Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science, using the MeSH terms “COVID-19,” “SARS-CoV-2,” “coronavirus,” “gestational diabetes,” “hyperglycemia” and “preeclampsia.” Only articles that were directly applicable to gestational diabetes and PE in COVID-19 was reviewed. We report that up-regulation of ACE2 leads to the overexpression of angiotensin II and AT1 receptor activity (Ang II/AT1). As the damaging effects of Ang II are intensified, SARS-CoV-2 stimulates ACE2 placental activity and Ang II-mediated sFlt-1 expression may contribute to the endothelial damage in SARS-CoV-2 infection through increasing Ang II/AT1 receptor interaction and/or hypoxia-inducible factor-1. This review provides an insight into the association between SARS-CoV-2 infection, gestational diabetes, and PE. As a result of the shared pathogenic traits, we assume that the anti-angiogenic milieu in high-risk pregnancies aggravates the susceptibility of a pregnant woman to high COVID-19 morbidity and mortality. In light of the growing burden of COVID-19 on global health-care systems, we highlight the urgency for appropriate management, treatment, and educational strategies to effectively control glycemic index in pregnancy.