bluuebunny/crossref_metadata_2025 huggingface dataset:
Pattern of traumatic occupational injuries in Saudi Arabia: A cross-sectional study
Authors: Abdel Razik Mohamed , Altuwayhir Abdulrahman Kareem , Almihmadi Mohammad Khaled , Alkhaldi Abdulrahman Ali , Alqudeebi Suliman Khaled , Alghamdi Mohammed Ali , Alsaiari Abdulhakim Abdullah , Aldosari Zayed Fahd , Alamer Ahmad Mohammed
Published: January 2023

ABSTRACT

Background:

In the Kingdom of Saudi Arabia (KSA), the labor market is thriving, employing a large workforce in occupations that carry a high risk for traumatic injuries such as construction, transportation, and manufacturing. These jobs usually involve physical exertion, power tools, high-voltage electricity, working at heights, and exposure to bad weather conditions that could potentially lead to injury. This study aimed to determine patterns of traumatic occupational injuries in Riyadh, KSA.

Methods:

A cross-sectional study was conducted at King Khalid Hospital and Prince Sultan Centre for Healthcare, Prince Sattam bin Abdulaziz University Hospital, and the Al-Kharj Military Industries Corporation Hospital in Al-Kharj City in the KSA between July 2021 and 2022. Descriptive analysis elucidated the type, severity, and patterns of management of non-fatal traumatic occupational injuries. A Kaplan–Meier survival curve and Weibull model for length of hospital stay adjusted for age, gender, nationality, cause for injury, and injury severity scale (ISS) scores were constructed.

Results:

A total of 73 patients with a mean age of 33.8 ± 14.1 years were included in the study. The most common cause of occupational injury was falling from height (87.7%). The median length of hospital stay was 6 days (IQR: 4 − 7), with no mortalities. In the adjusted survival model, compared to migrants, Saudi nationals had a 45% lower median hospital stay (−62 to − 21), P < 0.01, and every 1-point increase in ISS was associated with a 5% increase in median length of hospital stay (CI: 3 − 7, P < 0.01).

Conclusion:

Being a Saudi national and having lower ISS scores were associated with shorter durations of hospital stay. Our findings indicate the need for improved occupational safety measures, especially among migrant, foreign-born, and ethnic minority workers.
The yield of thyroid fine-needle aspiration in a primary care setting in Riyadh, Saudi Arabia
Authors: Ruhaiyem Mead E. , Al Khenizan Abdullah , Hussain Aneela
Published: January 2023

ABSTRACT

Background:

Thyroid cancer is the second most common cancer among women. This study was conducted to assess the yield of fine-needle aspiration (FNA) cytology of thyroid nodules in a primary care setting in Riyadh, Saudi Arabia.

Materials and Methods:

In this retrospective cohort study, primary care patients of both genders with thyroid nodules who underwent FNA above the age of 18 years were enrolled. Patients with a prior history of cancer were excluded. The data was collected from the histopathology reports of FNAs done for thyroid nodules from January 01, 2002 to July 31, 2018.

Results:

We enrolled 263 patients in this study. The mean age of the study population was 41.3 years old (Standard deviation (SD) ± 10.1), 81.7% were females and 18.3% were males. The rate of abnormal ultrasound (US) was 16%. The mean thyroid-stimulating hormone (TSH) level was 2.3 mU/L (SD ± 5.9). Post-thyroidectomy, 17.5% had carcinoma on pathology reports. Among those who were diagnosed with thyroid cancer, 76.2% had papillary thyroid cancer, 21.4% had follicular thyroid cancer, and 2.4% had medullary thyroid cancer. The mean age for cancer diagnosis was 40 years old (SD ± 8). There was no significant association between FNA findings (benign/malignant) and age, gender, history of smoking, size of the nodule, or TSH level.

Conclusion:

Thorough investigations including FNA should be considered for patients presenting with suspicious thyroid nodules, regardless of their size or the patients’ gender. Access to such investigations and referrals to specialists should be available for primary care physicians.
Lax skin and blurring of vision- A case report of pseudoxanthoma elasticum
Authors: Narasimhan Murali , Ramachandran R , Cornelius Gnanadurai J Samuel , Durai Priya Cinna T , Kalaivani P , Nithila C
Published: January 2023

ABSTRACT

Increased laxity of the skin can be caused by aging, significant weight loss, or defects in the elastic tissue. A 38-year-old female presented with increased laxity of the skin over the neck, thighs, and abdomen for 6 years, associated with headache and blurring of vision for a week. On cutaneous examination, prominent skin folds, laxity, and wrinkles were noted over the neck, abdomen, thighs, and groin, with yellowish papules along the neck creases. Ocular examination revealed features suggestive of angioid streaks. Skin biopsy showed fragmented elastic fibers and intervening calcium deposits on Verhoeff Van Gieson and Von Kossa stains. Based on these findings, a diagnosis of pseudoxanthoma elasticum (PXE) was made. The patient was started on oral and topical sunscreens and eye protection and advised regular follow-up. Diagnosing the condition early based on skin findings can help prevent further multi-system manifestations by taking appropriate preventive measures as this condition is progressive and has no cure.
Dyslipidemia in youth: Epidemiology, pathophysiology, screening, management, and treatment: A review of the literature
Authors: Esfarjani Shahla V. , Zakerkish Mehrnoosh
Published: January 2023

ABSTRACT

Atherosclerotic cardiovascular disease (ASCVD) is one of the major causes of death all over the world. Atherosclerosis is developed by atherogenic lipoproteins and inflammation. Thus, dyslipidemia (DLP) is a major risk factor for developing ASCVD. DLP is a condition characterised by unnaturally high levels of one or more lipid or lipoproteins in plasma. Although clinical manifestations of atherosclerosis are observed in middle age and above, atherosclerosis is a paediatric problem with a faster pathological procedure. Hence, increased awareness of the process of diagnosis, management, and treatment of children and adolescents with inherited or acquired DLPs among physicians and paediatricians is useful to prevent ASCVD in the future. The physicians and paediatricians must be aware of the current recommendations on DLP screening, pathophysiology, strategies for lifestyle modifications, pharmacotherapy, and guidelines for constant monitoring to better management of the disease. One of the most effective ways of managing DLP in childhood is to change lifestyle, in which parents have a critical role. In critical conditions, pharmacological interventions, along with changing lifestyle, may have significant effects on treating DLP. The aim of the present review was to investigate the epidemiology, pathophysiology, screening, management, and early treatment of DLP in youth. The data collected in this study increases our understanding of the importance of screening, management, and early treatment of DLP in order to prevent later risks and side effects that might even be life-threatening.
Effect of iron-fortified rice on the hemoglobin level of the individuals aged more than six months: A meta-analysis of controlled trials
Authors: Ramaswamy Gomathi , Yadav Kapil , Goel Akhil Dhanesh , Yadav Vikas , Arora Srishti , Vohra Kashish , Khanam Areeba , Kant Shashi
Published: January 2023

ABSTRACT

Fortification of staple food items with iron is a potential strategy to address anemia for a larger population. We reviewed studies to assess the impact of iron-fortified rice (IFR) on hemoglobin levels of individuals more than six months of age. We included studies assessing the effectiveness of IFR (with or without other micronutrients) conducted in any part of the world available in PubMed, Embase, Web of Science, Cochrane Library, Google Scholar, clinicaltrials.gov, International database of prospectively registered systematic reviews in health and social care (PROSPERO), unicef.org, and who.int databases and published from January 1, 1990 to April 1, 2019 (PROSPERO registration number: RD42020139895). We extracted the changes in hemoglobin, serum ferritin, and serum transferrin levels among the participants. Finally, data from 15 trials and their 21 subsets were analyzed. Mean difference in hemoglobin was 0.53 g/dl (95% CI: 0.26, 0.80, P < 0.001, I2 = 84%) in the IFR group compared to the control group. In the subgroup analysis after removing studies with small sample size and high risk for bias, a mean difference of 0.44 g/dl (95% CI: 0.20, 0.69, P < 0.001, I2 = 82%) was observed. No significant effect on serum ferritin or transferrin levels was observed. From this review it can be concluded that fortification of rice with iron can be adopted as an intervention to improve hemoglobin levels, especially in countries where rice is the major part food of staple diet. Research is needed on an optimal iron compound for fortification and the acceptance of IFR.
A case report of high-degree AV block in pregnancy
Authors: Joshi Arushi , Pillai Sheila K. , Vishwanath Usha
Published: January 2023

ABSTRACT

Complete heart block is seldom seen in pregnant women and poses a challenge for further management. The available literature on this is scarce, and the management usually varies as per the discretion of the obstetrician and severity of the presenting symptoms. Here, we report a case of a G2P0 primi with a high-degree AV block that was managed with a temporary cardiac pacemaker, which resulted in the successful delivery of twins. Clinically, we suspected a mitochondrial genetic defect to be the underlying cause of the conduction defect. Through this case, we would like to emphasize on the involvement of a multidisciplinary approach for the management of every pregnancy complicated by a medical disorder and the provision of timely interventions to reduce maternal and perinatal mortality.
Congenital heart disease – A complex cardiac anomaly: A case report
Authors: Lohakare Tejaswee , Maurya Archana , Kurian Bibin
Published: January 2023

ABSTRACT

Congenital heart disorders (CHDs) are a major cause of juvenile morbidity and mortality in many poor nations, owing to late detection and a lack of talent and facilities for decisive treatments. A case of a newborn baby with atrial septal defect (ASD) with patent ductus arteriosus (PDA), tricuspid atresia (TA), and pulmonary valve stenosis is admitted to the pediatric ward. It is a complex cardiac anomaly that leads to mortality and morbidity. We rarely get to see a baby dealing with four major complex heart conditions except in the condition of tetralogy of Fallot. The child was a known case of congenital heart disease. Symptomatic treatment was given and treated with antibiotics.
Sputum antibiogram in acute exacerbation of chronic obstructive pulmonary disease
Authors: Manjhi Rekha , Nanda Sushant Kumar , Agrawal Babul Kumar
Published: January 2023

ABSTRACT

Background:

Bacterial infections are the most common reason for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). This can range from self-limited disease to respiratory failure requiring mechanical ventilation and is associated with increased mortality and morbidity in survivors.

Aim:

To ascertain common antibiotics effective in AECOPD using sputum bacterial culture and antibiotic susceptibility testing. Materials and Methods: In the present cross-sectional observational study, we analysed the sputum antibiogram in 237 patients who had not received antibiotics in the past 48 hours. Statistical analysis was performed, and the χ2 test was used to determine the associations between categorical variables. A P value ≤0.05 was considered significant.

Results:

Of 237 sputum samples, 77.2% were mucoid in nature, followed by purulent and mucopurulent sputum in 16.9% and 5.9% of cases, respectively. In the purulent/mucopurulent samples, 85.2% showed positive growth on culture compared to 35% of mucoid samples. Cultures grew single pathogens in 108 cases, and 2 grew multiple pathogens; in 127 cases, no pathogenic organisms were isolated. In all, 41 (37.96%) isolates grew Gram-positive and 67 (62.04%) grew Gram-negative organisms. The most effective antibiotic against Gram-negative bacteria was imipenem (50%) and that against Gram-positive bacteria was vancomycin (70.59%). All isolates were resistant to ampicillin.

Conclusion:

Sputum culture is a good and simple tool to study the aetiology and complications caused by bacteria in AECOPD. The antibiogram helps in identifying the correct treatment and timely initiation of appropriate antimicrobial therapy, thereby helping reduce mortality and morbidity.
Forecasting HIV positivity through identification of predictors amongst high-risk women: A cohort study
Authors: Verma Mamtarani , Kosambiya J.K. , Divakar B.
Published: January 2023

ABSTRACT

Introduction:

High-risk women are the major drivers of India’s HIV epidemic. The targeted intervention (TI) project is working for the prevention and control of sexually transmitted infections (STIs) including HIV/AIDS among them. The current study was carried out among high-risk women to identify the predictors for HIV positivity through a model generation and assess the impact of targeted interventions in averting new HIV infections.

Aims and Objectives:

To generate the model for HIV positivity among high-risk women based on various independent variables using logistic regression analysis. Each year, how many HIV infections have been averted among them based on probability calculations of HIV positivity with positive and negative predictors?

Methodology: Study Design:

Prospective cohort with retrospective comparison.

Study Setting:

It was done at two different drop-in center clinics (DICs) and project field areas of the city.

Sample Size:

In total, 2,193 registered women availing services through NGOs/DIC clinics were enrolled.

Data Entry and Analysis:

Done using Excel and SPSS software. Association between the dichotomous dependent variables and continuous or categorical variables was assessed using the binary logistic regression model. Each year, how many HIV infections have been averted among them was calculated.

Results:

Statistically significant predictors of HIV positivity were alcohol consumption, category “A” and “C” women, partner status, regular medical check-ups, and attendance at counseling sessions. The number of HIV infections averted from 2009–10 to 2013–14 came out to be 52.

Conclusion:

Category C of high-risk women, alcohol consumption, and regular medical check-ups as (negative predictors) came out to be statistically significant predictors for HIV positivity.
Socio-demographic determinants of cardiovascular risk in rural population of Central India
Authors: Waghmare Pranita , Deshmukh Pradeep , Kumar Satish , Goswami Kalyan
Published: January 2023

ABSTRACT

Introduction:

Raising trend of cardiovascular diseases (CVD) in developing countries created a platform for exploring the sociodemographic nexus in search of underlying cause.

Aim and Objectives:

The precise aim of the study is to detect any possible association of social determinants and metabolic derangement with CVDs risk, particularly focusing on comparative analysis of the data to decipher the most significant factor(s), if any among the studied parameters contributing toward prediction of such cardiometabolic risk in linked with insulin resistance.

Results:

In the present study, it was found that 2% of the studied population had high risk, and 13.3% had intermediate risk of developing cardiovascular events in next 10 years. Results also showed that estimated CVD risk was significantly higher in males with central obesity and age more >60 years as key determinants showing more insulin resistance at lower cut-off.

Conclusion:

This study also strongly suggests need to revise the cut-off values for HOMA index in defining insulin resistance to rural population with active the life style and need of redefining new targeted preventive health care planning.
Assessment of knowledge of ASHA workers regarding MCH services and practices followed by mothers – A field study
Authors: Kaur Manhardeep , Oberoi Simmi , Singh Jatinder , Kaler Neha , Balgir Rajinder Singh
Published: January 2023

ABSTRACT

Background:

Accredited social health activist (ASHA) workers act as a “bridge” between rural people and health service outlets and play a central role in achieving national health and population policy goals. According to the National Family Health Survey (NFHS) V (2019–2021) data, infant mortality rate (IMR) is still high in rural areas (32.4 per 1000 live births) in Punjab, compared to urban areas (20.1). Maternal mortality ratio (MMR) is also high (129 per lakh), according to sample registration system (SRS) 2016–2018 data.

Materials and Methods:

In this descriptive, cross-sectional study conducted at RHTC, Bhadson, we assessed the knowledge of ASHA workers regarding maternal and child health (MCH) services and their provision by them to their beneficiaries (mothers with children aged 0–6 months). Out of the total 196 ASHA workers, 72 were selected randomly to assess their knowledge, while 100 beneficiary mothers were interviewed face to face to assess the services provided by the ASHA workers.

Results:

Almost 65.2% of ASHA workers were above 35 years of age. Majority of the ASHA workers (40/72) replied that average weight gain in pregnancy is 10 kg. Very few, that is, 17 (23.6%), ASHA workers knew that breastfeeding should be started within the first hour after delivery of the baby. Counseling regarding nutrition, birth preparedness, institutional delivery, and birth registration was given by ASHA workers to 75%–85% of mothers. There was statistically significant improvement in the practices by mothers with the counseling given by ASHA workers regarding pre-lacteal feed, utilization of family planning methods, and delaying early bathing.

Conclusions:

The study concludes that ASHA workers have good knowledge regarding various aspects of antenatal period, but when it comes to postnatal period and care of the newborn, there are some lacunae. These aspects of newborn care need to be reinforced into the refresher trainings of the ASHA workers.
The impact of socially accountable health professional education: Systematic review
Authors: Mahdavynia Soheila , Larijani Samaneh Saghafian , Mirfakhraee Hosna , Zandieh Zhale , Olamaeian Faranak , Tayebi Ali , Larijani Roshana Saghafian , Niksolat Maryam
Published: January 2023

ABSTRACT

Medical education is socially responsible for a global educational movement that transforms the development and presentation of medical schools in higher education. Therefore, in the present systematic review, we aimed to evaluate the impact of socially accountable health professional education. Published research articles were reviewed by searching the relevant terms invalid databases. In the initial search, 2340 records were obtained. At this stage, 1482 records were deleted due to duplication, and 773 records were removed due to indirect connection with the subject. Then, 85 articles were retrieved for full-text review. Finally, the complete review led to the selection of nine studies that met all inclusion criteria. Based on the results of the present systematic review, among the nine reviewed articles, four studies (44.44%) evaluated the effectiveness of social accountability on increasing the sense of empowerment, self-confidence, competencies such as teamwork, communication skills, and readiness for work. Three studies (33.333%) assessed the effectiveness of social accountability on providing further and better medical services and reducing infant mortality. Also, in two articles (22.22%), students’ lack of knowledge about social accountability was studied. Social accountability can help cultivate a healthy and skilled medical workforce and be effective in improving health services provided to the people. On the other hand, there are different perceptions and views on what social responsibility really is and how its effectiveness can be measured. Also, it is highly important to provide awareness in this regard for students.
Spectrum of toxicity due to pheniramine overuse in a COVID-19 patient. How much do we know?
Authors: Kamath Sangita D. , Upadhaya Ajatshatru , Mehta Neelam , Yadav Prabhakar
Published: January 2023

ABSTRACT

Pheniramine maleate is an easily accessible, potent antihistaminic compound used for the treatment of various allergic conditions. It acts on histamine one (H1) receptors on the central nervous system (CNS) and the peripheral tissues. It is a safe drug in therapeutic doses. However, overdoses as in suicidal cases, can result in serious, life-threatening drug-toxicity. These include atropine-like antimuscarinic effects like dryness of mucosal membranes, blurring of vision, hallucinations, CNS excitation such as irritability, insomnia, and seizures. Rhabdomyolysis can also occur as a result of its direct toxic effect on muscles, resulting in myoglobinuria, renal failure and electrolyte imbalance. Cardiotoxicity though rare, is also reported. We report a case of pheniramine maleate induced ventricular tachycardia, myoglobinuria with acute kidney injury (AKI) in a 20-year-old man who had consumed 50 tablets. He was incidentally also found to have SARS-CoV2 infection. However, timely intervention and aggressive supportive therapy helped in the recovery of the patient.
Carrier frequency of Spino-muscular atrophy in individuals of a reproductive age group from North India
Authors: Kaur Anupriya , Kumari Anu , Kaur Anit , Sharma Riya , Srivastava Priyanka , Suthar Renu
Published: January 2023

ABSTRACT

Introduction:

Spinal muscular atrophy (SMA) is a neuro-muscular disorder caused by biallelic variations in Survival Motor Neuron 1 gene (SMN1) located on chromosome 5q13.2. It is the most common hereditary cause of neonatal death. Ethnicity specific studies are desirable for estimating the prevalence of carrier status of this disease in a population.

Objectives:

To estimate the carrier frequency of SMA among individuals of a reproductive age group in a North Indian cohort.

Methods:

SMA carrier screening was offered to individuals of a reproductive age group (>18 years) visiting a tertiary care center. Multiplex ligation-dependent probe amplification (MLPA) and quantitative real-time polymerase chain reaction (PCR) were the molecular techniques used to detect the carrier status.

Results:

A total of 198 individuals without a family history of SMA were screened in this study. The carrier frequency of heterozygous deletion of SMN1 gene in our cohort was found to be 1 in 30 (~3/100).

Conclusion:

The carrier frequency of SMA is high in our country. The data from the study emphasize the need of a population carrier screening program on SMA in India.
Supervised hospital based pulmonary rehabilitation outcome in long COVID–experience from a tertiary care hospital
Authors: Rao C. Mohan , Behera Debasis , Mohapatra Amrut Kumar , Mohapatra Sangram Keshari , Jagaty Suman Kumar , Banu Princia , Pattanaik Ashwini Prasad , Mohapatra Ipsa , Patro Shubhransu
Published: January 2023

ABSTRACT

Introduction:

Some patients suffer from various multisystem symptoms even after active process of COVID-19 illness has settled lasting more than four weeks called as long COVID. Pulmonary rehabilitation therapy is the proposed option in those patients. This study aims to study the impact of pulmonary rehabilitation on outcome of long COVID patients through improvement in mMRC dyspnea scale, oxygen saturation, cough score, six-minute walk distance and biomarkers of inflammation

Materials and Methods:

A retrospective observational study was carried out from the data of electronic medical records among 71 Long COVID patients. Parameters like Spo2, MMRC scale, cough score, six-minute walking distance along with blood levels of D-dimer, C-reactive protein (CRP), leucocyte count at the time of admission and after three weeks of pulmonary rehabilitation were collected. The outcome among the patients was divided into full recovery and partial recovery group. Statistical analysis was done using SPSS software version 19.0.

Result:

Among 71 cases in our study 60 (84.50%) where male with mean age was 52.7 ± 13.23 years. Biomarkers like CRP and d-Dimer were elevated in 68 (95.7%) and 48 (67.6%) patients, respectively, at the time of admission. After 3 weeks of pulmonary rehabilitation mean SPO2, cough score, 6MWD showed significant improvement and normalization of biomarkers in recovered group of 61 out of 71 which was statistically significant.

Conclusion:

Significant improvement of oxygen saturation, mMRC grade, cough score, six-minute walk distance and normalization of biomarkers were marked following pulmonary rehabilitation. Thus, pulmonary rehabilitation therapy should be offered to all long COVID cases.
Evaluation of the effectiveness of triamcinolone solution diluted with normal saline for the treatment of seborrheic dermatitis
Authors: Jamali Fatemeh , Daneshdoust Danyal
Published: January 2023

ABSTRACT

Background and Aim:

Seborrheic dermatitis is a common inflammatory disease for which various treatments have been proposed. The main purpose of this study was to determine the effectiveness of 80-mg Triamcinolone solution diluted with 0.1% normal saline for the treatment of seborrheic dermatitis in adults.

Methods:

For this study, 120 patients with seborrheic dermatitis were considered. After obtaining written and informed consent, patients were treated with 80 mg of Triamcinolone diluted with 0.1% normal saline. To evaluate the effectiveness of Triamcinolone treatment, the scoring index (SI) and the level of patient satisfaction were evaluated at 2 and 4 weeks after the start of treatment and also 4 weeks after the end of treatment.

Results:

The results of the study showed that 61.67% (74 patients) were satisfied with “good” to “very good” for the Triamcinolone treatment to seborrheic dermatitis. Based on the findings of the study, it was found that the SI before treatment was equal to 2.45 ± 7.45, which after 2 weeks after treatment, this index decreased by 61.6% (SI: 2.86 ± 1.94). In addition, the SI decreased to 88.6% (SI: 0.85 ± 1.02) after 4 weeks.

Conclusion:

Considering the high decrease in SI, increasing patient satisfaction and observing a low number of cases with recurrence of the disease by Triamcinolone treatment method, it can be concluded that injection of Triamcinolone 80 mg diluted with 0.1% normal saline can be effective and efficient for the treatment of seborrheic dermatitis.
Athletes’ knowledge and attitude concerning the meniscus, meniscal injury, and management
Authors: Alqahtani Turki Ahmed A , Alshehri Talal K. S. , Kardum Saleh M. , Al-Qahtani Faisal M. M. , Alasmari Mishal M. A. , Alzahrani Faisal A. H. , Mahzari Faisal H. Y.
Published: January 2023

ABSTRACT

Introduction:

Knee injuries largely vary including cartilaginous, ligamentous, bony, and tendinous injuries. Greatest of the reported knee injuries associated with in a non-contact method includes mainly the anterior cruciate ligament (ACL). Additionally, medial and lateral menisci act as shock absorbers with an additional role in stabilizing the joint which can be or partially or totally torn. The current study aimed to assess athletes’ knowledge and attitude concerning the meniscus, meniscal injury, and management.

Methodology:

A descriptive cross-sectional study was conducted to achieve the objectives. A pre-structured electronic questionnaire was used to collect the data, covered participants socio-demographic data, personal and family history of meniscus injury and surgery, physical activity during past year, and also knowledge regarding the meniscal injury and management.

Results:

A total of 448 athletes fulfilling the inclusion criteria completed the study questionnaire. Participants ‘age ranged from 18 to 60 years with mean age of 26.7 ± 7.7 years old. A total of 256 (57.1%) participants were males. Exact of 21 participants had meniscus surgery. As for family history, 75 (16.7%) had family history of meniscus injury. Exact of 95 (21.2%) athletes had good knowledge level, while vast majority (78.8%; 353) had poor knowledge level.

Conclusions:

In conclusion, the study showed that the estimated rate of meniscus injury and surgery was not high (within the international range). The participants’ knowledge regarding meniscus injury and meniscus surgery with its related management was unsatisfactory, where 1 out of each 5 was knowledgeable.
Unilateral ‘Crazy-Paving’ pattern: An exceptional presentation of squamous cell carcinoma of the lung
Authors: Banday Sumeera , Khan Shamim U. , Khan Sabina , Anand Surinderpal S. , Shah Ashok
Published: January 2023

ABSTRACT

The ‘crazy-paving’ pattern on high resolution computed tomography (HRCT) is a distinct imaging appearance that is still considered to be a radiological hallmark of pulmonary alveolar proteinosis. However, since its first description about three decades ago, more than 40 different clinical entities presenting as ‘crazy-paving’ patterns have been documented. This rather remarkable but uncommon imaging appearance is now considered to be a non-specific manifestation. A 62-year-old male referred for evaluation of productive cough, breathlessness and fever presented with ‘crazy-paving’ pattern on HRCT. Endobronchial biopsy done on presentation was consistent with the diagnosis of squamous cell carcinoma. This report highlights this atypical presentation of squamous cell carcinoma of the lung and adds to the increasing list of clinical entities presenting as a ‘crazy-paving’ pattern. To our knowledge, squamous cell carcinoma presenting as a ‘crazy-paving’ pattern on HRCT is yet to be documented.
Investigating the barriers to clinical education among medical students in Iran: A narrative review study
Authors: Vahdat Sahar , Tanhaei Nazanin , Najafi Somayeh , Salemi Mohammad Hossein , Karbasian Fereshteh
Published: January 2023

ABSTRACT

Various factors can affect the clinical education of medical students. The main purpose of this study was to investigate the barriers to clinical educational related to medical students in Iranian universities of medical sciences. To conduct this study, all studies related to the subject under discussion, during the years 2000-2022, by systematically searching internationally available databases including Web of Science, Science Direct, Scopus, PubMed, and Google Scholar, were reviewed. Finally, 14 fully relevant studies were selected to investigate the main objective. The results of the present study showed that some factors, such as clinical environment, educational programs, facilities and equipment, number of students, how teaching professors, educators and hospital staff interacted with students, motivation and interest of students, hope for the future, job security and other similar parameters could affect the quality of clinical education. Based on the results of the present study, it can be concluded that the quality of clinical education in different universities of medical sciences is different and depended on many factors. Furthermore, it is necessary for the educational administrators of medical universities in Iran to identify the needs and shortcomings related to the clinical education of universities and then remove those barriers.
Posterior circulation infarct without apparent vertebral artery injury following realignment of atlantoaxial dislocation
Authors: Kataria Mandeep S , Salunke Pravin , Karthigeyan Madhivanan , Puneeth Shivanna
Published: January 2023

Abstract

Risk of injury to normal vertebral artery (VA) unlike that associated with an anomalous VA is infrequent during posterior C1–C2 reduction for congenital atlantoaxial dislocation (AAD). An ischemic event resulting from such indirect injury is a rare occurrence. A 14-year-old boy with severe AAD/basilar invagination underwent C1–C2 joint manipulation and fixation with an uneventful intraoperative course. Although his immediate postsurgical period was unremarkable, he sustained sudden and rapid neurological worsening on day 3. He developed multiple posterior fossa infarcts and finally succumbed. VA can be indirectly injured possibly due to excessive distraction/manipulation of C1–C2 joints. The lesson learnt is that anticipation of such injuries along with proactive anticoagulation treatment can potentially alter patient outcome.
Infantile Presentation of Villous Hyperplasia of Choroid Plexus as a Rare Cause of Hydrocephalus
Authors: Nitheesha Reddy V. , Sreekesh Pararathu Viswanathan , Gopalakrishnan M. S. , Sravani Nichanametla , Nagarajan Krishnan
Published: January 2023

Abstract

Villous hyperplasia of choroid plexus (VHCP) is a very rare benign condition characterized by diffuse enlargement of the choroid plexus with overproduction of cerebrospinal fluid (CSF), thus leading to shunt-resistant hydrocephalus in children. Although ultrasonography (USG) and computed tomography (CT) may aid in diagnosing the communicating hydrocephalus and choroid plexus enlargement, the diagnosis is essentially made on magnetic resonance imaging (MRI) by demonstrating diffuse enlargement and enhancement of the choroid plexus of the lateral ventricles diffusely, without any discrete masses. There are very few cases of this condition reported in the literature so far. In this report, we present a case of an infant presenting with hydrocephalus from VHCP and a brief review of the literature.
Elevation of depressed (pond) fracture in infant using a vacuum-assisted device: Technical note
Authors: Pateria Vibhor , Sadashiva Nishanth , Konar Subhas , Devi Bhagavatula Indira , Rewatkar Ajinkya
Published: January 2023

Abstract

Introduction:

Pond fracture also called ping-pong fracture in children is caused due to direct impact on the skull. It is rare and many types of treatment modalities have been described. In this report, we describe a makeshift vacuum-assisted device to elevate the fracture, which is both cost-effective and efficient.

Case presentation:

A 5-month-old infant was brought to the emergency department with a history of fall of heavy object on the head resulting in pond fracture over the left parietal area and an episode of focal motor seizures. After ruling out an intracranial injury with a computer tomogram, we elevated the depressed fracture by a makeshift vacuum suction device using a plastic funnel connected to vacuum chamber. Post-procedure child had one episode of focal seizure and was discharged after a brief period of observation.

Conclusion:

Plastic funnel vacuum suction can be effectively used to elevate the Pond fractures in infants with appropriate precautions.
A Rare Case of Spinal Extradural Teratoma With Mediastinal Extension
Authors: Macharla Dilip K. , Miryala Raveena , Mehrotra Kritin , Mehrotra Naveen
Published: January 2023

Abstract

Introduction:

Spinal extradural teratomas extending to posterior mediastinum are very rare and seldom reported.

Case Report:

A 4-year-old boy presented with progressive spastic paraparesis with sphincteric dysfunction was misdiagnosed as cerebral palsy. His magnetic resonance imaging showed D2-D5 extradural tumor, extending to the posterior mediastinum, causing severe thecal sac compression. Intraspinal part of the tumor was excised, and the child made a good recovery after the surgery. On histopathological examination, it was confirmed as a mature cystic teratoma.

Conclusion:

Spinal tumors with myelopathy may mimic cerebral palsy in children. To the authors’ knowledge, there are very few reported cases of spinal teratomas extending to the mediastinum.
BIG Score and Its Comparison with Different Scoring Systems for Mortality Prediction in Children with Severe Traumatic Brain Injury Admitted in Pediatric Intensive Care Unit
Authors: Zeeshan Arsheen , Jawwad Muhammad , Moazzam Mujtaba , Yousafzai Muhammad T. , Abbas Qalab
Published: January 2023

Abstract

Objective:

We aimed to determine the association of BIG score with mortality in pediatric traumatic brain injury (TBI) and its comparison with other trauma scores.

Materials and Methods:

A retrospective review of medical records of all children, aged 1–18 years, who were admitted in our pediatric intensive care unit within 24 h of trauma (from January 2015 to December 2018), was carried out. Data were collected on a structured case report form (CRF). They were analyzed using STATA version 15.

Results:

Ninety-four patients were identified. Data were collected on a structured CRF. Median BIG, Injury Severity Scoring (ISS), Pediatric Trauma Score (PTS), and New Injury Severity Score (NISS) were 15 (9.3–18), 13 (9–19), 4 (2–6), and 13 (9–22), respectively. Cutoffs for all scores were calculated using the Youden index, which was 19 for BIG score, 13.5 for ISS, 13.5 for NISS, and 3.5 for PTS. On the univariate analysis, younger age, tachycardia in the first 24 h, hypotension on arrival, base deficit, deranged international normalization ratio, low Glasgow Coma Scale and higher BIG score, higher ISS, and higher NISS scores were associated with mortality. Using the multivariate regression analysis, BIG score was associated with mortality. The BIG score had an area under the curve (AUC) of 0.802 (0.650–0.956) with the highest specificity of 90.5% (82.1–95.8%) and ISS had an AUC of 0.756 (0.702–0.810) with the highest sensitivity of 100% (69.2–100%).

Conclusion:

BIG and ISS are specific and sensitive scores, respectively, to predict mortality in pediatric TBI.
Pediatric Intraventricular Cavernous Hemangioma: A Neurological Rarity
Authors: Sarma Pragyan , Garg Manish Kumar , Chaturvedi Sujata , Pant Ishita
Published: January 2023

Abstract

Introduction:

Pediatric intraventricular cavernous hemangioma is a rare clinical entity. These categories of tumors in children pose a significant challenge to the treating neurosurgeon. We hereby report a case of cavernous hemangioma located in occipital horn of the lateral ventricle in a 10-year-old child supported by radiological and pathological evidence, which according to our literature search is a very rare phenomenon.

Clinical Case Report:

A 10-year-old male child was admitted with symptoms of raised intracranial pressure without any other clinical localizing signs. Magnetic resonance imaging (MRI) revealed an intraventricular lesion in the left occipital horn which was intensely hyperintense on T2-weighted (T2W) with contrast enhancement. He underwent gross total excision using a minimally invasive approach. Histopathology was suggestive of cavernous hemangioma. Postoperative recovery was uneventful.

Conclusion:

Intraventricular hemangiomas itself are very rare tumors. In published literature, till now only 28 such cases in pediatric population are reported. Although MRI provides useful clues to diagnosis, histopathological correlation is mandatory to confirm the diagnosis.
Intracranial migration of ventriculoperitoneal shunt: A rare complication
Authors: Diyora Batuk , Dubey Ashish
Published: January 2023

Abstract

Ventriculoperitoneal shunt is the commonest neurosurgical procedure being performed in the pediatric population. However, the procedure has its own list of complications. We present a case of complete intracranial migration of ventriculoperitoneal shunt in a 2-year-old male child.
Anesthetic Management for Functional Hemispherectomy in a Patient of Rasmussen’s Encephalitis: A Case Report
Authors: Mahajan Shalvi , Depuru Aparna , Narayan Vinitha , Kaur Kirandeep
Published: January 2023

Abstract

Rasmussen’s encephalitis (RE) is a rare inflammatory neurological disease, characterized by frequent and severe seizures, loss of motor skills and speech, hemiparesis (weakness on one side of the body), encephalitis (inflammation of the brain), and dementia. It is characterized by refractory epilepsy and progressive atrophy of one cerebral hemisphere. Here, we report a successful anesthetic management of a child with RE scheduled for functional hemispherectomy.
Desmoplastic infantile ganglioglioma: A rare entity
Authors: Diyora Batuk D , Chhajed Rahul M , Dhall Gagan , Patel Mehul
Published: January 2023

Abstract

Desmoplastic infantile ganglioglioma (DIG) is a very uncommon intracranial tumor with an incidence of 0.1%–1.25%. It is most often seen in the first 2 years of life. We describe two cases of this unusual entity in a 5-month-old boy and a 15-month-old child, both of whom had a history of convulsions and were diagnosed as DIG on histopathology after surgery. Gross total excision resulted in a successful treatment outcome without the requirement of any additional treatment.
Severe Hydrocephalus in an Infant with Ellis–van Creveld Syndrome: A Rare Entity
Authors: Kumar Shwetha P. , Vaithialingam Balaji
Published: January 2023

Abstract

Ellis–van Creveld (EVC) syndrome is an autosomal recessive condition due to mutation in EVC 1 and EVC 2 genes. The authors report the anesthetic management of EVC syndrome with raised intracranial pressure with concomitant congenital heart disease for emergency cerebrospinal diversion procedure.
Cyanotic Congenital Heart Disease with Moyamoya: A Rare Case Report
Authors: Kumar Munish , Raj Tulika , Suman Saurav , Naushaba Ghazala
Published: January 2023

Abstract

Moyamoya disease is an uncommon chronic, occlusive vascular disease, which causes obstruction and stenosis of arteries around the circle of Willis. Children and young adults are mainly affected. It may cause hemorrhagic or ischemic stroke, or transient ischemic attack. We report a rare case of association between congenital cyanotic heart disease and moyamoya syndrome.
Giant encephaloceles: Are always challenging task?
Authors: Harpanahalli Raghavendra , Kumar Maloth A , Prayaga Jyothsna , Srinivas Varkala , Arun Tirumala M , Joginipally Srinivas R , Reddy Aduma S , Varsha Karnam S
Published: January 2023

Abstract

Giant encephaloceles are rare entities with only one case series and few case reports reported in the medical literature. Encephaloceles which reach a size larger than the head size are called giant encephaloceles. We report a case of a 6-month-old child who had giant encephalocele with delayed motor milestones in the form of inability to hold neck. Because of their enormous size, they pose a surgical challenge. Anesthetic implications include difficulty in securing airway without undue pressure on the sac. The baby underwent ventriculoperitoneal shunt followed by excision of the encephalocele sac with repair. We report this case to highlight the difficulties in the management of giant occipital encephaloceles.
Odontoblasts in Health and Disease with an Additional Note on its Three-Dimensional Histological Perspective
Authors: Tamgadge Sandhya , Tamgadge Avinash , Agre Bhagyashree Pradeepkumar , Pendse Gayatri , Nayak Amisha
Published: January 2023

Teeth are considered to be the prime organs for mastication, speech, and esthetics. The basic structure of tooth involves enamel, dentin, and pulp. Each of these is formed by specialized structures during the various phases of tooth development. One of such specialized structures forming dentin of the tooth are odontoblasts. Being present at the periphery of the pulp chamber, they are in close contact with dentin through cytoplasmic extensions which travel into the entire length of dentin through dentinal tubules. In addition to dentin formation, they play a vital role in performing the various functions of the tooth including nerve sensation. They are functionally active throughout the life span of a healthy tooth and are subjective to numerous injuries causing various oral lesions. This review aims to collect the information with an additional note on the role of odontoblasts and their characteristics in a healthy and diseased tooth structure, their significance in endodontics and three-dimensional (3D) histological means.
A Cluster of Japanese Spotted Fever Cases Associated with Cemetery Visits in Wakayama City, Japan
Authors: Kobayashi Ken-ichiro , Utatsu Nobuko , Kanbe Chisa , Niu Tetsuya , Terasoma Fumio , Ando Shuji , Kubo Kenji , Komiya Nobuhiro
Published: January 2023

Japanese spotted fever (JSF) is a tick-borne rickettsiosis caused by Rickettsia japonica. Although the number of JSF cases has been increasing, exceeding 300 per year since 2017, clusters of cases are rare. Here, we report a cluster of seven JSF cases, the first nonfamilial cluster of the disease documented in the Japanese literature, and describe the management of the outbreak through prompt investigation and control-and-prevention measures performed collaboratively by members from the clinical, laboratory, and public health fields. All seven cases in the cluster had visited a cemetery in September or October of 2019. R. japonica was detected in whole-blood and/or skin samples from six patients and in the larvae of Haemaphysalis hystricis collected in a field survey. The evidence suggested that this cluster of cases was caused by the conjunction of two circumstances within a short period of time: an increase in the number of visitors to a cemetery during a Buddhist event and an increase in the number of infectious tick larvae in the cemetery through hatching (vertical transmission from infected females). Delays in the treatment of JSF can lead to severe manifestations. Early interventions through collaborative efforts among members from the clinical, laboratory, and public health fields are important for controlling outbreaks, raising the awareness of the public, and diagnosing and treating patients.
Gillespie, Abraham Lincoln Jr (1895–1950)
Authors: Setz Cathryn
Published: January 2023

Abraham Lincoln Gillespie Jr was a writer, poet, and contributor to Maria Jolas and Eugene Jolas’s Little Magazine Transition. Known as ‘Linky’ or ‘Link’ to his friends, Gillespie’s writing was arguably the most flamboyant and eccentric of all the magazine’s Anglophone avant-garde content. Texts such as ‘Music Starts a Geometry’ (1927) and ‘Textighter Eye-Ploy or Hothouse Bromidick?’ (1928) combined visual aspects of the mathematical diagram with their pronouncements on modern language, which also nodded to Guillaume Apollinaire’s ‘Caligrammes’, or graphic word-poems.
Wie wird man Klassiker?: Rainald Goetz im Suhrkamp Verlag
Authors: Glück Florian
Published: January 2023

With his novel ‘Irre’, Rainald Goetz becomes a Suhrkamp author in 1983. This article traces the homogenizing effects of his authorship at the publishing house, focusing in particular on the paratexts of his books. Between scene awareness and Suhrkamp culture, Rainald Goetz succeeds in integrating different attention resources, reading contexts, and reception groups into his work politics.
Etnopolítica mapuche-pehuenche: escenarios de reemergencia indígena en Malargüe, Argentina
Authors: Soto Oscar
Published: January 2023

La estatalidad liberal hegemónica, implica la anulación de cuerpos indígenas como fundamento de un sistema capitalista con ropajes de civilización dominante. En tal sentido, el tipo de racismo perenne aquí analizado, conforma la operación política y cognitiva por excelencia capaz de predicar un crisol de razas bajo la idea de nacionalidad, encubriendo así formas de represión y exclusión territorial. Se reflexiona aquí en torno de los procesos de organización política e identitaria surgidos en los marcos de la redemocratización argentina y su consiguiente traducción en espacialidades de resistencias indígenas invisibilizadas, especialmente al sur de la provincia de Mendoza (Argentina). En particular nos detenemos sobre la experiencia de lucha de las comunidades mapuche/pehuenche articuladas a la organización Malalweche, en el territorio de Malargüe. Intentamos conjugar aquí una mirada teórico-crítica con la reivindicación política de una resistencia ancestral en constante reemergencia.