bluuebunny/crossref_metadata_2025 huggingface dataset:
Commercialization of Smallholder Farmers in Mutale Municipality of Vhembe District of Limpopo
Authors: Zwane Elliot Mahlengule , Nekhavhambe Elekanyani
Published: March 2023

This chapter seeks to discuss and assess the concept of commercialization of smallholder farmers, and whether it is a reality or a myth. The focus of the study area was the former Mutale Local Municipality, in Vhembe district of Limpopo Province in South Africa, drawn from 4 areas namely Tshipise, Tshixwadza, Tshishivhe, and Masisi agricultural zones by using a sample of 153 small holders drawn randomly. The problem of the study was that there are more than 4 million households engaged in agriculture in South Africa who in are engaged in subsistence farming. If these farmers can be assisted, they can feed the nation. Data were collected through a structured qualitative and quantitative questionnaire that was administered face-to-face to respondents and the data was analysed by using a computer programme of the SPSS Version 24. The findings suggest that farmers need support in different aspects such as training, extension, and comprehensive support by the government
Agricultural Marketing Dynamics in the Face of Climate Change
Authors: Tshikororo Mpho
Published: March 2023

Climate change is instrumental for agricultural performance, with its production and marketing being the leading cores. Although numerous climate change adaptive strategies have been identified, there is a need to explore how climate change impacts agricultural marketing. The focus of the study was to investigate the agricultural marketing dynamics brought by the impact of climate change among rural-based emerging farmers. The study was conducted in the Vhembe district of the Limpopo province. A simple random sampling technique was used to select the participants, while a structured questionnaire was used to collect data. Discriminant analysis was used to draw a distinct difference between farmers who had observed the impact of climate change on their marketing dynamics from those who didn't. The study results show that unstable selling prices have been a negative impact of climate change on the market. The study recommended that collaborative efforts be directed toward assisting farmers in enhancing their marketing practices.
Grameen Bank as an Economic Stabilizer for the Rural Banking Sector in Bangladesh
Authors: Alam Md Hussin
Published: March 2023

Grameen Bank has gained a significant position in the global microfinance sphere that ensures the presence of the poor in the mainstream financial scenario. The Grameen Bank microfinance concept has been adopted in over 40 countries and has had significant success in a variety of societies. This bank has served 9.44 million clients and 2,568 branches. GB provides services in 81,678 villages, covering more than 93% of the total villages in Bangladesh. In order to get a loan from the GB, rural women have to be extremely poor. This bank's intention is to remove poverty and unemployment through the business and make them economically self-sustainable. GB works in Bangladesh and developing countries. GB has drawn global attention because of its aims and easy money lending mechanism to the rural poor people for making themselves financially strong and diminishing the rate of poverty and unemployment.
Role of Knowledge in Creativity and Innovation in the Service Sector
Authors: Weerasinghe Salinda , Sedera Darshana
Published: March 2023

The present study aimed to explore the role of knowledge management practices in promoting creativity and innovation in the service sector concerning the banking industry. The study assumes knowledge as an intangible internal asset and innovation as a way to develop sustainable strategic capabilities that are difficult to imitate. This quantitative study tested five proposed hypotheses on 437 responses collected from banking employees through the PLS-SEM method. Light indicated that knowledge sharing, application, and protection directly contributed to firm innovation, whereas knowledge creation encounters complete mediation through employee creativity. The study combines RBV and KM perspectives in developing long-term strategic capability and strengthens the evolutionary view of economists that new knowledge is based on existing knowledge, conforming the effect of knowledge protection to knowledge sharing. The study develops a knowledge management framework incorporating working/operational knowledge protection as one of the main dimensions of the knowledge management process.
Embracing Business Sustainability Through Innovation and Productivity in the Automotive Sector
Authors: Bolton Anthony D. , Goosen Leila , Kritzinger Elmarie
Published: March 2023

The purpose of the study reported on in this chapter was to explore and attempt to answer the primary research question: To what extent can embracing business sustainability through digital transformation, implemented via unified communication and collaboration (UC&C) technologies, impact innovation and productivity in the global automotive sector? This will be presented against the background of embracing business sustainability through innovation and creativity in the service sector. Apart from creativity, collaboration, and generating savings featured in the subtitle of the chapter, changing work practices were also identified as a factor impacting innovation.
Application of Brain-Inspired Computing for Daily Assistance
Authors: Diwan Princy , Dewangan Bhupesh Kumar
Published: March 2023

The domains of artificial intelligence and machine learning continue to advance at a rapid speed in terms of algorithms, models, applications, and hardware thanks to an exponential increase in the amount of data collected on a daily basis. Deep neural networks have transformed these domains by achieving extraordinary human-like performance in various real-world challenges, such as picture or speech recognition. There is also a lot of effort going on to figure out the principles of computation in extensive biological neural networks, especially biologically plausible spiking neural networks. Neural-inspired algorithms (e.g., deep ANNs and deep RL) and brain intelligent systems have revolutionized the fields of machine learning and cognitive computing in the last decade, assisting in a variety of real-world learning tasks ranging from robot monitoring and interaction at home to complex decision-making about emotions and behaviors in humans and animals. While these brain-inspired algorithms and systems have made significant progress, they still require large data sets to train, and their outcomes lack the flexibility to adapt to a variety of learning tasks and provide long-term performance. To solve these issues, an analytical understanding of the concepts that allow brain-inspired intelligent systems to develop information, as well as how they might be translated to hardware for everyday help and practical applications, is required. This chapter focuses upon the applications, challenges, and solutions of brain-inspired computing for daily assistance.
Study and Innovative Approach of Deep Learning Algorithms and Architecture
Authors: Dewangan Omprakash
Published: March 2023

Deep learning is becoming increasingly important in our everyday lives. It has already made a big difference in industries like cancer diagnosis, precision medicine, self-driving cars, predictive forecasting, and speech recognition, to name a few. Traditional learning, classification, and pattern recognition methods necessitate feature extractors that aren't scalable for large datasets. Depending on the issue complexity, deep learning can often overcome the limitations of past shallow networks that hampered fast training and abstractions of hierarchical representations of multi-dimensional training data. Deep learning techniques have been applied successfully to vegetable infection by plant disease, demonstrating their suitability for the agriculture sector. The chapter looks at a few optimization approaches for increasing training accuracy and decreasing training time. The authors delve into the mathematics that underpin recent deep network training methods. Current faults, improvements, and implementations are discussed. The authors explore various popular deep learning architecture and their real-world uses in this chapter. Deep learning algorithms are increasingly being used in place of traditional techniques in many machine vision applications. Benefits include avoiding the requirement for specific handcrafted feature extractors and maintaining the integrity of the output. Additionally, they frequently grow better. The review discusses deep convolutional networks, deep residual networks, recurrent neural networks, reinforcement learning, variational autoencoders, and other deep architectures.
Ambient Assisted Living (AAL) Systems to Help Older People
Authors: Komalasari Rita
Published: March 2023

There is significant interest in the development and implementation of smart and intelligent ambient assisted living (AAL) systems that can give daily support to help older people live independently in their homes. Additionally, such systems will lower the expense of healthcare that governments must bear in order to provide support for this group of residents. It also relieves families of the burden of constant and often tedious round-the-clock surveillance of these individuals, allowing them to focus on their own lives and commitments. As a result, recognition, classification, and decision-making for such people's daily activities are critical for the development of appropriate and successful intelligent support systems capable of providing the essential assistance in the correct manner and at the right time.
Brain-Inspired AI to a Symbiosis of Human Intelligence and Artificial Intelligence
Authors: Dewangan Omprakash
Published: March 2023

Brain-based artificial intelligence has been a popular topic. Applications include military and defense, intelligent manufacturing, business intelligence and management, medical service and healthcare, and others. In order to strengthen their national interests and capacities in the global marketplace, many countries have started national brain-related projects. Numerous difficulties in brain-inspired computing and computation based on spiking-neural-networks, as well as various concepts, principles, and emerging technologies in brain science and brain-inspired artificial intelligence, are discussed in this chapter (SNNs). The advances and trends section covers topics such as brain-inspired computing, neuromorphic computing systems, and multi-scale brain simulation, as well as the brain association graph, brainnetome, connectome, brain imaging, brain-inspired chips and devices, brain-computer interface (BCI) and brain-machine interface (BMI), brain-inspired robotics and applications, quantum robots, and cyborgs (human-machine hybrids).
Performance Analysis of Pre-Trained Convolutional Models for Brain Tumor Classification
Authors: Chauhan Rishabh , Aggarwal Garima
Published: March 2023

Brain tumor is a common tumor and is damaging depending upon the type of tumor and the stage at which it is diagnosed. It is revealed by a doctor using magnetic resonance imaging of the brain. Analyzing these images is an exacting task, and human intervention might be a scope of error. Therefore, applying deep learning-based image classification systems can play a crucial role in classifying several tumors. This chapter aims to implement, analyze, and compare pre-trained convolutional neural network models and a proposed neural architecture to classify brain tumors. The dataset includes 7000 images classified into four classes of tumors: glioma, meningioma, no tumor, and pituitary. The proposed methodology involves cautious analysis of data and the development of a deep learning model. This has produced testing results with high accuracy of 99.0% and an error rate of 6.8%. According to the experimental findings, the proposed method for classifying brain tumors has a respectable level of accuracy and a low error rate, making it an appropriate tool for use in real-time applications.
IL-4 Predicts the Efficacy of a Candidate Antioxycodone Vaccine and Alters Vaccine-Specific Antibody-Secreting Cell Proliferation in Mice
Authors: Crouse Bethany , Baehr Carly , Hicks Dustin , Pravetoni Marco
Published: March 2023

Opioid use disorders (OUDs) are a public health concern in the United States and worldwide. Current medications for OUDs may trigger side effects and are often heavily regulated. A novel treatment strategy to be used alone or in combination with existing medications is active immunization with antiopioid vaccines, which stimulate production of opioid-specific Abs that bind to the target drug and prevent its distribution to the brain. Although antiopioid vaccines have shown promising preclinical efficacy, prior clinical evaluations of vaccines targeting stimulants indicate that efficacy is limited to a subset of subjects who achieve optimal Ab responses. We have previously reported that depletion of IL-4 with a mAb increased opioid-specific IgG2a and total IgG, and it increased the number of germinal centers and germinal center T follicular helper cells in response to antiopioid vaccines via type I IL-4 signaling. The current study further investigates the mechanisms associated with IL-4–mediated increases in efficacy and whether IL-4 depletion affects specific processes involved in germinal center formation, including affinity maturation, class switching, and plasma cell differentiation in mice. Additionally, results demonstrate that preimmunization production of IL-4 after ex vivo whole blood stimulation predicted in vivo vaccine-induced Ab titers in outbred mice. Such mechanistic studies are critical for rational design of next-generation vaccine formulations, and they support the use of IL-4 as a predictive biomarker in ongoing OUD vaccine clinical studies.
Psychological distress, coping strategies and social support among HIV positive patients in Calabar, Nigeria
Authors: Edet Bassey Eyo , Odo Michael Odey , Kolawole Olubukola , Essien Emmanuel , Okafor Chidi John , Atu. Ginini Edward  Eko
Published: March 2023

The Human Immunodeficiency Virus (HIV) infection substantially impacts psychological and emotional wellbeing via various mechanisms. The role of coping strategies and social support in the mental health of People Living with HIV (PLWH) is under-investigated. This study aimed to determine the prevalence of anxiety and depression and their relationship with coping and social support among PLWH. This cross-sectional study involved 251 patients selected using systematic sampling from the HIV Clinic of the General Hospital, Calabar, Nigeria. A sociodemographic questionnaire was administered along with the Hospital Anxiety and Depression Scale to measure anxiety and depression. Participants were also administered the 32-item Coping Strategies Inventory and the Oslo Social Support Scale to measure coping strategies and social support, respectively. The respondents were mostly female (72.5%) and had a mean age of 35.3 [SD=10.9]. The prevalence of anxiety and depression was 27.1% and 19.5%, respectively. Both anxiety and depression had significant negative associations with problem-focused engagement, emotion-focused engagement and problem-focused disengagement, and significant positive associations with emotion-focused disengagement (p<0.01). Social support was poor and had a significant negative association with anxiety, significant positive associations with problem-focused engagement, emotion-focused engagement and problem-focused disengagement, and significant negative associations with emotion- focused disengagement (p<0.01). Our study highlights the importance of coping strategies and social support among PLWH. Based on findings, adaptive coping and social support protect PLWH from deterioration in their mental health. In addition, PLWH with good social support might cope better with the diagnosis.
Effects of piperlonguminine on lung injury in severe acute pancreatitis via the TLR4 /NF-κB pathway
Authors: Hu Qian , Tao Ran , Hu Xiaoyun , Wu Haibo , Xu Jianjun
Published: March 2023

Acute pancreatitis is an inflammatory response in the pancreas, involving activation of pancreatic enzymes. Severe acute pancreatitis (SAP) often causes systemic complications that affect distant organs, including the lungs. The aim of this study was to explore the therapeutic potential of piperlonguminine on SAP-induced lung injury in rat models. Acute pancreatitis was induced in rats by repetitive injections with 4% sodium taurocholate. Histological examination and biochemical assays were used to assess the severity of lung injury, including tissue damage, and levels of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 (NOX2), nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 4 (NOX4), reactive oxygen species (ROS), and inflammatory cytokines. We found that piperlonguminine significantly ameliorated pulmonary architectural distortion, hemorrhage, interstitial edema, and alveolar thickening in rats with SAP. In addition, NOX2, NOX4, ROS, and inflammatory cytokine levels in pulmonary tissues were notably decreased in piperlonguminine-treated rats. Piperlonguminine also attenuated the expression levels of toll-like receptor 4 (TLR4) and nuclear factor-kappa B (NF-κB). Together, our findings demonstrate for the first time that piperlonguminine can ameliorate acute pancreatitis-induced lung injury via inhibitory modulation of inflammatory responses by suppression of the TLR4/NF-κB signaling pathway.
Geotargeting spatial and temporal data of Italian freshwater high-altitude macroinvertebrates
Authors: Boggero Angela , Dumnicka Elzbieta , Fornaroli Riccardo , Paganelli Daniele , Zaupa Silvia
Published: March 2023

A data set including information on macroinvertebrates identified to genus/species group/species level was created within the monitoring activities of several European and national projects. The data set includes 2111 macroinvertebrate records on temporal fragmentary data from lakes Paione (upper, middle, and lower lakes Paione), and 530 records on spatial data relative to eight other high-altitude lakes from the Ossola Valley (North-western Italy, Piedmont, Central Alps). The study area is included within the Lake Maggiore watershed. All records are georeferenced because, since the beginning of the studies, temporal data were taken in the same sampling sites over years. The temporal data span over the period 1989-2020, the spatial data refer to the 2019-2020 sampling activity. The dataset is available for download as csv format at the Global Biodiversity Information Facility (GBIF) data infrastructure.
Extraction, Purification, and Anti-Inflammatory Activity of Steroid Fraction from Physalis Alkekengi L. Var. Franchetii (Mast.) Makino
Authors: Xia Tian-Yi , Wang Yi , Yang Yan-Ni , Wang Wu-Jing , Ding Zi-He , Zhong Ren-Xing , Chen Ying , Li Wei , Peng Ming-Ming , Li Chuan-Qiu , Shang Li-Feng , Liu Bing , Wang Zhen-Yue , Shi Chong-Rong , Shu Zun-Peng
Published: March 2023

Objective:

As a traditional medicinal plant listed in the Chinese Pharmacopeia, Physalis alkekengi L. var. franchetii (Mast.) Makino (PAF) has a long medicinal history and high economic value. PAF has immunomodulatory properties and can be used to treat acute lung injury and eczema. The aim of this study is to solve the problems of extraction and purification of active components from PAF.

Materials and Methods:

The solvent to be used for extraction and its concentration, the solid-to-liquid ratio, and extraction duration were investigated using a single-factor experiment. An orthogonal design (L9[34]) was used to determine the optimum extraction conditions. After optimization, the sample's concentrations and flow velocity, the eluents and their velocity, adsorption time, and the removed water volume were measured. The content of the five steroids in the sample was determined by high-performance liquid chromatography (HPLC). We also investigated the anti-inflammatory property of PAF calyxes before and after purification.

Results:

The optimum extraction and purification processes were determined by single-factor analysis. AB-8 was identified as the best macroporous adsorption resin for enrichment. After optimization, the average total steroid content was 71.83%, and the average recovery was 90% after purification. Among the five steroid components detected by HPLC, physalin F showed the highest content. Furthermore, the sample obtained after purification could significantly inhibit paw edema by egg whites induced.

Conclusions:

An environmentally-sustainable, efficient, and stable process was first optimized for enriching and purifying total steroids from PAF. The process has the potential for further development and utilization in the pharmaceutical industry.
Efficacy and Duration of Electro-Acupuncture Combined with Conventional Antipsychotics for Schizophrenia
Authors: Huang Zhao-Han , Fang Yuan , Yu Qi , Wang Tong
Published: March 2023

Introduction:

This study aimed to evaluate the effectiveness and optimal course time of electro-acupuncture (EA) combined with conventional antipsychotics in the treatment of schizophrenia (SZ) and to provide a basis for its clinical application.

Methods:

Relevant databases and authoritative websites were retrieved, and references were screened up to May 2021. Literature quality evaluation and data extraction were carried out according to the requirements of Cochrane version 5.1.0, and meta-analysis was conducted using Rav Man5.4 software.

Results:

In total, 16 randomized controlled trails comprising 1352 patients were selected. Meta-analysis revealed that the observation group showed greater improvements than the control group in total clinical efficacy (P < 0.00001, odds ratio [OR] = 3.51, 95% confidence interval [CI] = [2.51, 4.91]), as well as better effective rate of symptom relief (P = 0.02, MD = 3.08, 95% CI = [1.23, 7.71]), and an improved negative symptom score (P = 0.005, MD = −4.50, 95% CI = [−6.52, −2.48]), positive symptom score (P < 0.0001, MD = −1.41, 95% CI = [−2.25, −0.57]), total score (P = 0.001, MD = 9.25, 95% CI = [13.03, 5.47]), and general psychopathological score (P < 0.0001, MD = −2.30, 95% CI = [−4.18, −0.43]) in the Positive and Negative Syndrome Scale (PANSS). However, there was no statistically significant difference between the two groups in the effective rate of adverse reactions (P > 0.05). In the 4–6 weeks following treatment, a significant improvement in all the four components of the PANSS scores was observed in the observation group.

Conclusion:

The efficacy of EA combined with conventional antipsychotics for SZ is better than that of psychiatric drugs alone. In addition, the effect of a 4-to 6-week treatment course on each outcome index is more significant, and the efficacy is higher.
Surgical anatomy of breast—Editorial commentary
Authors: Chintamani
Published: March 2023

Abstract

Understanding surgical anatomy forms the basis of all breast surgeries ranging from minor lump excisions to the most radical surgeries. Planning of all oncoplastic procedures requires a sound knowledge of perforators, fascial patterns and recent understanding of various vascular pedicles including Wuringer Septum.
Intraoperative Ultrasound-guided Wide Local Excision
Authors: Rubio Isabel , Joshi Sneha , Mishra Rupa
Published: March 2023

Abstract

There has been an increasing push to identify alternative novel technologies for the identification of non-palpable tumours. This article explains the feasibility of using ultrasound intraoperatively to identify and excise sub-clinical lesions.
Delivering high-value breast care
Authors: Dietz Jill R , Joshi Sneha , Dewle Ankush
Published: March 2023

Abstract

Focusing only on survival and recurrence outcomes can lead to breast cancer overtreatment, high costs, and poor patient experience. Providing care through the lens of the patient improves value in breast cancer treatment.
Effect of Amoxicillin and Azithromycin Suspensions on Microhardness of Sliver Reinforced and Nano Resin-Modified Glass Ionomers
Authors: Hasan Zainab R. , Al-Hasani Noor R. , Mahmood Maha Abdulkareem , Ibrahim Ali I.
Published: March 2023

Introduction:

We aimed to examine the effect of amoxicillin and azithromycin suspensions on the microhardness of sliver-reinforced glass ionomer and nano-resin modified glass ionomer (GI).

Method:

Thirty discs (2 mm height x 4 mm diameter) of each type of GI were prepared, which were randomly assigned to amoxicillin, azithromycin, and artificial saliva groups. Microhardness was evaluated by Vickers hardness test before and after three immersion cycles.

Results:

The overall model (P <  0.001), before/after intervention (P <  0.001), intervention group (type of antibiotic) (P = 0.013), and type of glass ionomer (P <  0.001) showed significant differences among study groups (P <  0.001). Post hoc test showed only non-significant before/after difference for Azithromycin and artificial saliva (control) groups regarding nano resin-modified GI.

Conclusion:

We found significant microhardness loss for sliver reinforced GI in comparison to nano resin-modified GI after the immersion cycles. Yet, sliver reinforced GI would have higher level of microhardness than nano resin-modified GI after the immersion cycles. Longer time studies are required to assess trend of microhardness loss.
Effect of addition of polymerized polymethyl methacrylate (PMMA) and zirconia particles on impact strength, surface hardness, and roughness of heat cure PMMA
Authors: Rasan Duaa Subhi , Farhan Firas Abdulameer
Published: March 2023

Introduction:

This study was designed to examine the effects of addition of the combination of polymerized polymethyl methacrylate (PMMA) and zirconia (ZrO2) particles to heat cure PMMA resin on impact strength, surface hardness, and roughness.

Methods:

The 70% (w/w) of polymerized PMMA powder (particle size: 0.70 µm) was mixed with 30% (w/w) of zirconia powder (ZrO2) (1 µm) to produce PMMA-ZrO2 filler. Ninety acrylic specimens created were divided into three groups containing 0% wt (Control group), 2% wt, and 4% wt, PMMA-ZrO2 filler. Ten specimens were used for impact strength, surface hardness and roughness test, blindly. Data were analyzed via one-way ANOVA and the Tukey post hoc test using R 3.6.3.

Results:

There was statistically significant difference among study groups regarding surface hardness and roughness (p < 0.001). Yet, nonsignificant difference was found on the subject of impact strength (p = 0.33). Post hoc test showed statistically significant difference for all pairwise comparisons as regards surface hardness and roughness (p < 0.05).

Conclusion:

The incorporation of PMMA-ZrO2 filler did not improve impact strength (resistance during an unexpected blows or dropping). Yet, increased surface roughness and hardness, concentration-dependently.
Clinical Profile and Short-Term Outcomes of Patients Admitted with Acute Pulmonary Embolism in a Tertiary Care Centre
Authors: Pai Vinayak , Ambekar Suyash , Nadkar Milind , Mulkalwar Alhad , Prajjwal Priyadarshi
Published: March 2023

Background:

Venous thromboembolism is a major contributor to the global disease burden, with an incidence of around 10 million cases per year and substantially associated morbidity and mortality.

Objectives:

The study aimed to assess the clinical, laboratory, and radiological profile along with electrocardiogram and echocardiogram changes and the treatment and outcomes in patients admitted with acute pulmonary embolism (PE) in a tertiary care centre. The etiologies and risk factors of the same were also evaluated.

Materials and Methods:

This was a hospital-based prospective observational study conducted among 31 patients over a period of 18 months. The study was conducted at a tertiary care centre in the Department of General Medicine. Patients of age more than 12 years, admitted with a confirmed diagnosis of acute PE based on computed tomography pulmonary angiography (CTPA), were included in the study.

Results:

Thrombolysis was done in 12.9% cases, while anticoagulants were given in 87.1% cases. Oxygen therapy was required in 74.2% cases on day 1 while in 9.7% on day 30. Secondary pulmonary hypertension was the commonest complication observed in the study, in 54.8% cases. Severe hypoxia was seen in 35.4% cases. No complications were seen in 6.4% cases. Mortality was recorded in 9.6% of the cases.

Conclusion:

Since PE is among the leading causes of death and disability, there should be a high degree of suspicion in all clinical settings. And since prolonged immobilisation is a strong risk factor for PE patients at risk, they should be offered prophylactic anticoagulation.
Impact of Coronavirus Disease (COVID-19) on Reproductive Health
Authors: Falana Benedict A. , Obembe Olawale O. , Adeleke Opeyemi S. , Adefolaju Gbenga A. , Tokunbo Olorunfemi S.
Published: March 2023

The coronavirus disease (COVID-19) is a communicable respiratory disease caused by a new strain of coronavirus that causes illness in humans. The disease is caused by a pathogen called Severe Acute Respiratory Syndrome Coronavirus-2 and can be transmitted from person to person through infected air droplets that are projected during sneezing or coughing. The coronavirus disease has generally affected all sectors of the society, including the health sector and reproductive health in particular. Reproductive health contributes greatly to physical and psychosocial comfort and closeness between individuals. Adequate and balanced reproductive health can be impaired and deprived by diseases, abuse, exploitation, unwanted pregnancy, and death. This review paper looked into possible effects of COVID-19 pandemic on reproductive health. Human and nonhuman primate literatures were examined to extract empirical data detailing the impact of COVID-19 on reproductive health. Literatures were sourced from Ovid MEDLINE, SCOPUS, the Cochrane Library, Ovid EMBASE, CINAHL Plus, PROQUEST, PUBMED, and Web of Science. Experimental and clinical evidence were used to examine whether COVID-19 adversely impacted on the reproductive health of infected and non-infected population. The global outbreak of COVID-19 has led to measures driven by the pandemic, to prevent further spread and effectual treatment of those affected. This has literally caused decrease in sexual and reproductive health care services due to global lockdowns and closures of health sectors deemed to be non-essential in combating the disease.
Demand for Plastic Surgery Services via Inpatient Referrals in a Nigerian Teaching Hospital
Authors: Achebe Uchechukwu J. , Okwesili Obinna R. , Onumaegbu Okechukwu O.
Published: March 2023

Background:

Plastic surgery is one of the most collaborative surgical specialties and is also considered the most consulted service in a hospital. Plastic surgeons respond to many medical consults or inpatient referrals, and the comprehensive impact of these services, when they are nonoperative, often goes unnoticed.

Objectives:

The objectives of the study were to assess the nature of demands of plastic surgery services for admitted patients in a teaching hospital and the specialties and types of patients that benefit from them.

Materials and Methods:

Clinical records of inpatients evaluated by plastic surgeons were retrieved using a compendium of consults received from other specialties within the hospital over a period of 1 year period.

Results:

The plastic surgeons received a total of 151 hand-written consults from surgeons, physicians, gynecologists, and pediatricians. The vast majority came from physicians (45.7%) and surgeons (40.4%). Among the physicians, endocrinologists sent the highest number of consults (42.5%). Ulcers constituted the commonest reason for inpatient referrals (66.2%). Over 29% of consults were for patients with primary diagnosis of diabetes mellitus, whereas 13.9% were for head injuries.

Conclusions:

The demands for the services of plastic surgeons come from virtually all the clinical specialties in a tertiary hospital. The commonest reason for such referral is for their review and management of ulcers. There is a need to utilize telemedicine in reducing the burden of reviewing these patients, especially in large tertiary hospitals.
Blood Transfusion Reactions and Institutional Hemovigilance Protocols
Authors: Aneke John C. , Chigbo Chisom G. , Emeh Perpetua O. , Ifediata Francis , Efobi Chilota C. , Chilaka Ugochinyere J. , Ibekwe Nkechinyere T. , Ezeh Theodora U. , Aneke Chiamaka B.
Published: March 2023

Background:

Blood transfusion reactions contribute significantly to the morbidity and mortality of both in- and outpatients in hospitals globally. Developing adequate protocols for detecting and reporting this complication is key to attaining global blood transfusion safety.

Objective:

The objective of the study was to review the frequency of blood transfusion reactions and the adequacy of institutional hemovigilance efforts in a Nigerian hospital.

Materials and Methods:

Records of patients that had blood transfusion reactions (cases) and those that did not (controls) were analyzed over a 2-year period. Sociodemographic information, transfusion and admission histories, primary diagnoses, as well as transfusion reaction details (where applicable) were recorded. Data were analyzed using STATA 16.1 (StataCorp. 2019, Stata Statistical Software: Release 16, College Station, TX: StataCorp LLC). Sociodemographic characteristics were presented in frequency tables and charts, whereas relationships between study variables were compared using the Chi-square and the Person Correlation. P value less than 0.05 was considered to be statistically significant (confidence level = 95%).

Results:

One death was recorded among the cases during the study, whereas febrile nonhemolytic reactions constituted the most type of reaction (41.5%). Only 37.5% of reactions were investigated, and none was reported to the hospital blood transfusion/hemovigilance committee. There was no significant association between the study-related variables and the type of reaction or the likelihood of experiencing a new reaction with subsequent transfusions (P values all > 0.05).

Conclusion:

Febrile reactions are the commonest complication of blood transfusion in our data set; institutional hemovigilance efforts remain suboptimal and should be further strengthened.
Knowledge of Hand Hygiene and Use of Alcohol-Based Hand Rub Among Interns in a Nigerian Tertiary Health Facility
Authors: Ogugua Ifeoma J. , Achigbu Kingsley I. , Chukwumam Denning M. , Ejim Chioma A. , Enabulele Eunice O. , Friday-Edeh Chioma F. , Nwoga Hope O. , Nwazor Ernest O. , Mafuka Johnson S. , Akunne Somtochukwu R.
Published: March 2023

Background:

Healthcare-associated infections and antimicrobial resistance are both largely prevented through hand hygiene. There are still gaps in hand hygiene knowledge and routine use of alcohol-based hand rub among healthcare workers.

Objectives:

This study assessed the knowledge of hand hygiene and the use of alcohol-based hand rub among interns at the University of Nigeria Teaching Hospital, Enugu State, Nigeria.

Materials and Methods:

A cross-sectional study was conducted among 230 interns using a structured WHO hand hygiene knowledge questionnaire. A two-stage sampling technique was employed. Descriptive and inferential statistics were carried out and p-value was set at ≤ 0.05.

Results:

Two respondents (0.9%) had good knowledge of hand hygiene while slightly more than half (117/230, 50.9%) had moderate knowledge. Also 50.9% (n = 117) used alcohol-based hand rub. Majority of the respondents, 140 (60.9%) had attended training in hand hygiene. Sex was significantly associated with the knowledge of hand hygiene (p=0.03) as male respondents had a higher proportion of good knowledge while having received training on hand hygiene was significantly associated with routine use of hand hygiene (p=0.004).

Conclusions:

Since only very few of the interns had overall good knowledge of hand hygiene, targeted structured training on hand hygiene and infection prevention and control practices to improve the knowledge of such healthcare workers is highly recommended.
Can Gartner’s Duct Cyst Trigger Marital Disharmony? A Case Report
Authors: Jimoh Olanrewaju S. , Lemboye-Bello Rofiat T. , Ogunjinrin Olawale O. , Alayo Adewale M.
Published: March 2023

Gartner’s duct cyst (GDC) is a remnant of the mesonephric (Wolffian) duct in females. The GDC is formed from the persistence of some portions of the mesonephric duct in adult females resulting in small-sized cysts usually in the anterolateral vaginal wall but could be found elsewhere along the tract of the duct. The case of a 33-year-old para 5+1 (three alive) woman who had GDC is reported. The patient presented with incidental findings of a vaginal mass during gynecological evaluation and subsequently had dyspareunia. A provisional diagnosis of GDC was made and this was confirmed by transvaginal ultrasound. The patient had transvaginal excision of the cyst and histological confirmation of a benign cystic lesion with the diagnosis of GDC. GDC is a rare entity and clinical examination revealing a cystic vaginal wall mass with or without symptoms should raise a high suspicion of this condition.
Recanalization of pelvic ureter in pelvic neoplastic obstruction: Technical approach
Authors: Chatar Achraf , El Anzaoui Jihad , Akjay Ali , Ammani Abdelghani
Published: March 2023

Introduction:

Obstruction of the lower ureter by pelvic cancer requires palliative treatment. Percutaneous derivation is often performed in an emergency context. If the obstruction is limited to the perimeatic area; the percutaneous antegrade recanalization can be performed and may require a resection of the ureteral orifice.

Objectives:

We evaluate the results of percutaneous antegrade recanalization associated with possible bladder resection in the treatment of pelvic neoplastic ureteral stenosis.

Materials and Methods:

A retrospective, descriptive study from September 2016 to January 2021 included all patients with complicated pelvic tumor with ureteric hydronéphrosis. Under general anesthesia, in Valdivia modified position, a nitinol hydrophilic guidewire is passed through the nephrostomy and retrieved from the bladder to the urethral meatus, followed by a descent of ureteral catheter under X-ray control. We might need a resection over the presumed ureteric meatus as it will help open the lower extremity of the ureter, so it can be easily catheterized with a double J. When needed, the resection is performed in the modified Valdivia position, it requires significant vigilance and the resection is controlled by fluoroscopy by visualizing the proximity of the resector and the guidewire in the ureter.

Results:

In our study, 74 patients, including 29 men and 45 women, with an average age of 65 years (52–78 years). The Karnofsky index was ≥≥80% 80% in 92% and between 80% and 60% in 8% of patients. The average extent of ureteral stenosis was 2.25 cm (1–3.5 cm). The etiologies of obstruction were dominated by cervix cancer at 58.2%, followed by prostate cancer at 33.7% and bladder cancer at 8.1%. The recanalization is carried out in 40% on the left, 60% on the right, and bilaterality in 30% of the cases. In the event of bilateral obstruction, the repermeabilization was carried out in two deferred stages, one side at a time, the priority kidney being the one which seemed more functional with a good corticomedullary index. The improvement of renal function in 82%, however, 18% progressed to chronicity. The disappearance of the dilatation was present in 85%, whereas 15% of the cases presented a residual dilation without alteration of the renal function. The resection of the ureteral meatus was performed in 75% of the cases. We had only one recanalization failure in our series because the stenosis was extensive, due to the intrinsic invasion of the ureter by the tumor. A few complications were noted: pyelonephritis (7%), isolated flank pain (10%), and bladder irritative syndrome (13%). The average survival of these patients depended essentially on pelvic cancer responsible for the obstruction, ranging from 11 months to 45 months.

Conclusion:

Percutaneous recanalization associated with bladder resection is an attractive, reproducible, and well-tolerated technique. Very few complications are reported. It provides a good quality of life to patients.
Complex urinary reconstruction in a case of genitourinary tuberculosis post micturating cystogram bladder perforation
Authors: Pirzada Faisal Masood , Shreyas N. M. , Sharma Umesh
Published: March 2023

Voiding cystourethrogram (VCUG) is done for lower urinary tract disorders. Even though easy to perform, can be associated with serious complications if not done properly. A sound knowledge of the technicalities and what is being expected of the study is essential. Different factors such as patient age, underlying diseases, and proper technique are important factors to be kept in mind. Here, we present a 26-year-old female of genitourinary tuberculosis (GUTB) with lower urinary tract symptoms (LUTS). While undergoing evaluation for LUTS refractory to medical therapy, VCUG study was done which was complicated by bladder perforation with spillage of contrast into the peritoneal cavity. Patient was managed conservatively and later complex triple urinary reconstruction was done by left ileocalicostomy with orthotopic neobladder (ONB) with right ureteric reimplantation. While performing VCUG, proper technique should be used and due principals to be followed, especially in cases of GUTB by the attending doctor to avoid rare but grievous complications like bladder perforation. Complex reconstructive surgery is possible but is extremely challenging and should be offered to the patients with very good results.
Advances in reconstructive urology: A review of the 2022 literature
Authors: Bearrick Elizabeth , Sterling Joshua , Simhan Jay , Nikolavsky Dmitriy
Published: March 2023

Reconstructive urology encompasses a broad spectrum of lower and upper urinary tract diseases. A recent society of genitourinary reconstructive mission statement emphasized the desire to promote and support research in the growing fields of tissue engineering, device design, patient-reported outcomes, and validated measurement tools for urethral stricture disease. The purpose of this article was to identify and highlight the high-impact recent literature published within reconstructive urology during the past year. Original research, systematic reviews, and videos from the Gold Journal, BJUI, World Journal of Urology International, SIU Journal, Neurourology Urodynamics, Journal of Urology, and European Urology were included.
Anastomotic urethroplasty as management for iatrogenic posterior urethral injuries in an infant
Authors: Desai Devang , Joshi Pankaj , Raveenthiran Sheliyan , G De Win , Kulkarni Sanjay
Published: March 2023

Introduction:

Boys born with high imperforate anus have a rectourethral fistula, which usually occurs at the prostatomembranous junction. A recent trend has been to perform a single-stage posterior sagittal posterior anorectoplasty (PSARP) with pull-through and closure of the rectourethral fistula. Inadvertent posterior urethral injury during repair may result in traumatic obliteration of the posterior urethra. Posterior urethral injury is also possible after other procedures such as ablation of posterior urethral valves (PUVs). We evaluated our outcomes of posterior anastomotic urethroplasty in such infants.

Materials and Methods:

We managed four infants with posterior urethral injury after PSARP and one after endoscopic ablation of PUVs during 2012–2018 at our institution. Iatrogenic injury was noticed post-PSARP on the removal of the urinary catheter. Suprapubic catheter (SPC) was subsequently inserted. Retrograde urethrogram, voiding cystourethrogram, and endoscopy through the SPC tract and urethra were performed before undertaking an anastomotic urethroplasty.

Results:

Three infants required crural separation and inferior pubectomy. Four infants had an uneventful recovery. One infant had an annular narrowing at the anastomotic site and required endoscopic urethrotomy twice. We waited till the child was older (age 4) and performed urodynamics. This revealed obstructive uropathy. The patient subsequently underwent redo anastomotic urethroplasty with crural separation and inferior pubectomy. He had an uneventful recovery. Our follow-up ranged from 1 to 7 years.

Conclusions:

Iatrogenic urethral injuries are rare in infants. Anastomotic urethroplasty achieves physiological voiding and prevents complications of prolonged SPC. Even though surgery is challenging, our series suggests that it is feasible with good outcomes.
High-risk Human Papillomavirus (hrHPV) Prevalence and Genotype Distribution Among Turkish Women
Authors: Gecer Melin
Published: March 2023

Purpose:

This study aimed to determine the rates of distribution of high-risk HPV (hrHPV) genotypes according to cervical smear samples and biopsy results in a large sample of Turkish women.

Methods:

The study was conducted with 4,503 healthy volunteer women aged 19-65 years. Samples of cervical smears were collected during the examination and liquid-based cytology was used for the Pap tests. The Bethesda system was used for reporting the cytology. High-risk HPV genotypes including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68 were investigated in samples. The study cohort was grouped according to age in decades, with comparisons made according to these age groups, Bethesda class, and cervix biopsy results.

Results:

Among all cases, 903 (20.1%) participants were positive for 1074 hrHPV-DNA genotypes. HPV-DNA positive cases were most common in the 30-39 age group (28.0%), followed by women under the age of 30 (38.5%). HPV genotypes were determined as, in order of frequency: Other hrHPV (n = 590, 65.3%), HPV16 (n = 127, 14.1%), Other HPV + HPV16 (n = 109, 12.1%), HPV 18 (n = 33, 3.6%), and Other HPV + HPV 18 (n = 32, 3.5%). Cervical smears were reported as ASCUS in 304 (6.8%) samples and high-grade squamous intraepithelial lesion (HSIL) in 12 (0.3%) of the samples. Biopsy demonstrated the presence of HSIL in 110 (12.5%) participants, with 644 (73.3%) negative cases.

Conclusion:

This showed an increasing incidence of Other HPVs besides the known importance of HPV 16 and 18 genotypes as risk factors for cervical cancer.
Endoscopic Transnasal Transpterygoid Biopsy of the Trigeminal Nerve
Authors: Aldahlawi Moataz M.S , Hachem Ralph Abi
Published: March 2023

Metastatic involvement of the trigeminal nerve is a rare manifestation of malignant neoplasms. Squamous cell carcinoma of the head and neck, lymphoma, and lung and colon cancers are reported to affect Meckel's cave. Little is known to why tumors may metastasize and involve some branches of the trigeminal nerve. In case of suspicious lesions, an endoscopic transnasal biopsy approach into the pterygopalatine and the infratemporal fossa is an option. An endoscopic transnasal transpterygoid approach to the Meckel's cave and middle cranial fossa is described in our case. Neurosurgical literature reports that open approaches to this area subject the brain parenchyma to stretch forces that render gaining full access somewhat challenging. The choice of approach should be tailored to the case and the size of the tumor and the prognosis of the patient. In our reported case, the biopsy was performed in the described technique without complications or a major cerebrospinal fluid leak.