bluuebunny/crossref_metadata_2025 huggingface dataset:
The hospitalization rate and clinical characteristics of mucormycosis prior and during COVID-19 pandemic: A single-center study
Authors: Estakhr Mehrdad , Ghotbi Zahra , Rostamihosseinkhani Mahtab , Hooshmandi Etrat , Janipour Masoud , Ostovan Vahid Reza , Fadakar Nima , Bazrafshan Hanieh , Bahrami Zahra , Rahimi-Jaberi Abbas , Poursadeghfard Maryam , Nazeri Masoumeh , Kouhi Pariya , Petramfar Peyman , Izadi Sadegh , Barzegar Zohreh , Nikzadeh Ehsan , Sasannia Sarvin , Arsang-Jang Shahram , Tabrizi Reza , Khademi Behzad , Kohandel-Shirazi Mahsa , Salehi Mohammad Saied , Ashjazadeh Nahid , Khademi Bijan , Ashraf Mohammad Javad , Eilami Owrang , Roudgari Amir , Moghaddami Mohsen , Zomorodian Kamiar , Badali Hamid , Borhani-Haghighi Afshin
Published: July 2023

Introduction: There have been some reports of the association between SARS-CoV-2 infection and mucormycosis. This study aims to compare the hospitalization rates and clinical characteristics of mucormycosis before and during the COVID-19 pandemic.
Methodology: In this retrospective study, we compared the hospitalization rate of mucormycosis patients in Namazi hospital in Southern Iran for two periods of 40 months. We defined July 1st, 2018 to February 17th, 2020, as the pre-COVID-19 period and February 18th, 2020, to September 30th, 2021, as the COVID-19 period. In addition, a quadrupled group of hospitalized patients with age and sex-matched SARS-COV-2 infection without any sign of mucormycosis was selected as the control group for COVID-associated mucormycosis.
Result: In the total of 72 mucormycosis patients in the COVID period, 54 patients had a clinical history and a positive RT-PCR, which confirms the diagnosis of SARS-COV2 infection. The hospitalization rate of mucormycosis showed an increase of + 306% (95% CI: + 259%, + 353%) from a monthly average value of 0.26 (95% confidence interval (CI): 0.14, 0.38) in the pre-COVID period to 1.06 in the COVID period. The use of corticosteroids prior to the initiation of hospitalization (p ≤ 0.01), diabetes (DM) (p = 0.04), brain involvement (p = 0.03), orbit involvement (p = 0.04), and sphenoid sinus invasion (p ≤ 0.01) were more common in patients with mucormycosis during the COVID period.
Conclusions: In high-risk patients, especially diabetics, special care to avoid the development of mucormycosis must be taken into account in patients with SARS-COV-2 infection considered for treatment with corticosteroids.
The evaluation of the relationship between COVID-19 and autoimmune responses with a cross-sectional trial using medical records
Authors: Yilmaz Ebru , Küçük Salih
Published: July 2023

Introduction: Several previous studies have suggested a link between autoimmune activation and SARS-CoV-2 infection. This study aims to evaluate the excessive immune response via laboratory and radiological findings, treatment options, and previous acute phase reactants in patients with mild and moderate coronavirus disease 2019 (COVID-19) to identify the possible interaction between autoimmune response and SARS-CoV-2 infection.
Methodology: A total of 345 hospitalized patients with a diagnosis of definitive COVID-19 were evaluated retrospectively in terms of their clinical, laboratory, and radiological data, comorbidities, treatment options, and the values of C-reactive protein (CRP) of all patients in the last year before COVID-19 during admission to the hospital for any reason.
Results: 162 (47%) of the patients were female and 183 (53%) were male. The mean age was 51.08 ± 15.52 years. Of all patients, 235 (68.1%) had mild disease and 110 (31.9%) had a moderate disease. There was a statistically significant difference between the two groups in terms of age, gender, the values of leukocytes, lymphocytes, and hemoglobin, the levels of AST, LDH, Na, Cl, Ca, CRP, ferritin and fibrinogen, duration of hospitalization, medical treatments as well as the CRP value of the patients in the last year. Male gender, shortness of breath, duration of hospitalization, the value of lymphocytes, and the levels of LDH, CRP, and fibrinogen were independent predictive factors for the severity of COVID-19.
Conclusions: The SARS-CoV-2 infection could act as a triggering factor for developing autoimmune and/or autoinflammatory dysregulation in genetically predisposed individuals.
The risk of mother-to-child transmission of hepatitis B virus infection in Ethiopia: A systematic review and meta-analysis
Authors: Taye Belaynew W , Ayenew Girum Meseret , Wasie Taye Zewdu , Balew Melashu , Bishaw Taye Eden
Published: July 2023

Introduction: Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is a predominant route of infection for children in Ethiopia. No study has so far reported a nationwide estimate of the risk of MTCT of HBV. We conducted a meta-analysis of surveys and estimated the pooled risk of MTCT of HBV in the context of human immunodeficiency virus (HIV) infection.
Methodology: We searched PubMed, EMBASE, Web of Science, Africa Index Medicus, and Google Scholar databases for peer-reviewed articles. The pooled risk of MTCT of HBV was estimated using the DerSimonian-Laird technique with logit transformed proportions and statistical heterogeneity was estimated using I2 statistic, which was explored by subgroup and meta-regression analyses.
Results: The overall pooled risk of MTCT of HBV in Ethiopia was 25.5% (95% CI, 13.4%–42.9%). In women without HIV infection, the risk of MTCT of HBV was 20.7% (95% CI 2.8%–70.4%), and 32.2% (95% CI 28.1%–36.7%) in women with HIV infection. After excluding the outlier study, the risk of MTCT of HBV in studies that included only HIV negative women was 9.4% (95% CI, 5.1%–16.6%).
Conclusions: The risk of MTCT of HBV in Ethiopia widely varied by HBV/HIV coinfection. A sustainable control and elimination of HBV in Ethiopia requires improved access to birth-dose HBV vaccine and implement immunoglobulin prophylaxis for exposed infants. Given the limited health resources in Ethiopia, prenatal antiviral prophylaxis integrated with antenatal care may be a cost-effective approach to significantly reduce the risk of MTCT of HBV.
Improved results on an extended dissipative analysis of neural networks with additive time-varying delays using auxiliary function-based integral inequalities
Authors: Shanmugam Saravanan , Vadivel R. , Rhaima Mohamed , Ghoudi Hamza
Published: July 2023

The issue of extended dissipative analysis for neural networks (NNs) with additive time-varying delays (ATVDs) is examined in this research. Some less conservative sufficient conditions are obtained to ensure the NNs are asymptotically stable and extended dissipative by building the agumented Lyapunov-Krasovskii functional, which is achieved by utilizing some mathematical techniques with improved integral inequalities like auxiliary function-based integral inequalities (gives a tighter upper bound). The present study aims to solve the $ H_{\infty}, L_2-L_{\infty} $, passivity and $ (Q, S, R) $-$ \gamma $-dissipativity performance in a unified framework based on the extended dissipativity concept. Following this, the condition for the solvability of the designed NNs with ATVDs is presented in the form of linear matrix inequalities. Finally, the practicality and effectiveness of this approach were demonstrated through four numerical examples.
Three solutions for a three-point boundary value problem with instantaneous and non-instantaneous impulses
Authors: Zhang Huiping , Yao Wangjin
Published: July 2023

In this paper, we consider the multiplicity of solutions for the following three-point boundary value problem of second-order $ p $-Laplacian differential equations with instantaneous and non-instantaneous impulses:

   \begin{document}$ \begin{equation*} \left\{ {\begin{array}{l} -(\rho(t)\Phi_{p} (u'(t)))'+g(t)\Phi_{p}(u(t))=\lambda f_{j}(t,u(t)),\quad t\in(s_{j},t_{j+1}],\; j=0,1,...,m,\\ \Delta (\rho (t_{j})\Phi_{p}(u'(t_{j})))=\mu I_{j}(u(t_{j})), \quad j=1,2,...,m,\\ \rho (t)\Phi_{p} (u'(t))=\rho(t_{j}^{+}) \Phi_{p} (u'(t_{j}^{+})),\quad t\in(t_{j},s_{j}],\; j=1,2,...,m,\\ \rho(s_{j}^{+})\Phi_{p} (u'(s_{j}^{+}))=\rho(s_{j}^{-})\Phi_{p} (u'(s_{j}^{-})),\quad j=1,2,...,m,\\ u(0)=0, \quad u(1)=\zeta u(\eta), \end{array}} \right. \end{equation*} $\end{document}

where $ \Phi_{p}(u): = |u|^{p-2}u, \; p > 1, \; 0 = s_{0} < t_{1} < s_{1} < t_{2} < ... < s_{m_{1}} < t_{m_{1}+1} = \eta < ... < s_{m} < t_{m+1} = 1, \; \zeta > 0, \; 0 < \eta < 1 $, $ \Delta (\rho (t_{j})\Phi_{p}(u'(t_{j}))) = \rho (t_{j}^{+})\Phi_{p}(u'(t_{j}^{+}))-\rho (t_{j}^{-})\Phi_{p}(u'(t_{j}^{-})) $ for $ u'(t_{j}^{\pm}) = \lim\limits_{t\to t_{j}^{\pm}}u'(t) $, $ j = 1, 2, ..., m $, and $ f_{j}\in C((s_{j}, t_{j+1}]\times\mathbb{R}, \mathbb{R}) $, $ I_{j}\in C(\mathbb{R}, \mathbb{R}) $. $ \lambda\in (0, +\infty) $, $ \mu\in\mathbb{R} $ are two parameters. $ \rho(t)\geq 1 $, $ 1\leq g(t)\leq c $ for $ t\in (s_{j}, t_{j+1}] $, $ \rho(t), \; g(t)\in L^{p}[0, 1] $, and $ c $ is a positive constant. By using variational methods and the critical points theorems of Bonanno-Marano and Ricceri, the existence of at least three classical solutions is obtained. In addition, several examples are presented to illustrate our main results.
E-assessment during the Coronavirus Outbreak from the Perspective of Undergraduate at the University of Sharjah, UAE
Authors: Balsam Qubais Saeed  , Najeh Rajeh Al Salhi  , Salman Yousuf Guraya  , Sami Sulieman Al Qatawneh  , Mohd. Elmagzoub Eltahir  , Ahmed Omar Adrees  , Kubais Saeed Fahady  , Nagaletchimee Annamalai
Published: July 2023

— The aim of the current research was to detect how undergraduates from the faculties of medicine, dentistry, pharmacy, and health sciences felt about using electronic assessment at the time of COVID-19. Cross-sectional research was made at the University of Sharjah in UAE between January and April 2021. As a study tool, a questionnaire with 26 items was created using Google Forms and disseminated by the registration department via the learner's E-learning platforms. The study's data were analyzed using SPSS software. The outcomes demonstrated that students had a high level of acceptance of the computerized assessment. The overall arithmetic mean of the students' replies was (3.49) and had a standard deviation of (1.33), indicating that they accepted the electronic assessment to a high degree. Furthermore, there was a discernible difference between the acceptance of the internet-based assessment by male and female students, but the College of Medicine (COM) students benefited significantly from the variation in acceptance of the assessment depending on the variable of college. Students who had inadequate computer capacities, on the other hand, were more receptive to electronic testing. The study's findings may be helpful in developing academic methods, rearranging assessment alternatives, and changing the academic curriculum to address the problems and limitations of electronic assessment.
Estereotipos distópicos en el cine latinoamericano a través de El Club (Pablo Larraín, Chile, 2015) y Zama (Lucrecia Martel, Argentina, 2017)
Authors: Murillo María Dolores de los Ángeles
Published: July 2023

El Nuevo Cine Latinoamericano desde mediados del siglo XX a la actualidad es muy rico en títulos, contenidos, lugares y personajes distópicos. En este artículo hemos seleccionado dos obras y dos autores de amplio palmarés, totalmente novedosos y rompedores, pues convierten a los lugares periféricos del continente latinoamericano y a personajes excluidos en paradigmas de una narrativa fílmica singular que apuesta por la distopía.
Historiography and the Making of the Sultan’s Court in 15th Century Cairo. The case of the court office of ‘the Chief Head of the Guards’ (raʾs nawbat al‑nuwab)
Authors: Steenbergen Jo Van , Termonia Maya
Published: July 2023

This article addresses the changing organization of the leadership of the Syro-Egyptian sultanate of Cairo between the late 14th and the early 16th centuries. Our aim is to further the understanding of how Arabic manuals of courtly protocol and texts of history from the 15th and early 16th centuries were active participants in a contested discourse of state formation that was directly involved in this changing organization on the one hand and that, on the other hand, mediated all medieval and modern encounters with it. Representations of the office of ‘the Chief Head of the [sultan’s] Guards’ (raʾs nawbat al-nuwab) are foregrounded here as a case study and a representative example of these discursive agencies. Exploring the representation of ‘the Chief Headship’ by 15th- and early 16th century scribes and historians as well as by modern scholars, this article demonstrates how they all, one way or another, participated in the sultanate’s complex processes of courtly configuration and state formation.
Does board diversity really matter to shareholders?
Authors: Blomkvist Magnus , Redor Etienne
Published: July 2023

Does board diversity really matter to shareholders? To answer this question, we depart from the traditional approach of analysing the impact of board diversity on firm value to instead concentrate on shareholder voting outcomes in annual director elections. By exploring a hand-collected dataset, we identify that diversity matters to shareholders. New to the literature, we find that shareholders’ greater support for diverse directors is driven by votes for minority directors. Specifically, we show that non-Caucasian female directors can fully explain the greater shareholder approval for female directors. Our study has implications for board selection and shows that board diversity is valuable to shareholders.
“They paved the Atlantic with books”: William and Jenny Bradley, literary agents and cultural passeurs across borders
Authors: Cossu-Beaumont Laurence
Published: July 2023

The William A. Bradley Literary Agency Records help trace the careers of William and Jenny Bradley, two intermediaries in the cultural exchanges between France and the United States in the twentieth century. The archive offers privileged access to an array of transatlantic negotiations in the interwar period and post-Second World War era. This article first aims at including the two agents into the communications circuit relevant to book history that unfolds from writer to editor and on to reader, at a time when the book industry became more international. The article then unveils the sociability rooted in the agents’ participation in the world of Parisian salons and in the building of literary and intellectual relationships in the transnational space of Paris. Ultimately, the article argues that the Bradleys’ lifework articulates cultures in ways that defy the simplified vision of a unidirectional flux in what has been suggested to be an “American Century” of influence and cultural domination. In sum, an interest in intermediation and a transnational approach bring together considerations over the professional contributions of the French-American literary agents and observations about little-known makers of cultural processes. This article draws from the manuscript of Deux agents littéraires dans le siècle américain : William et Jenny Bradley, passeurs culturels transatlantiques (Cossu-Beaumont, 2023) and hopefully serves to shed light on the journeys of William and Jenny Bradley as Atlantic passeurs.
Literacy Level and Self-Perceived Confidence of using Office Suite Applications among First Year Postgraduate Medical Students
Authors: Khan A. M. , Majhi N. , Gupta P.
Published: July 2023

Purpose: Basic knowledge of Office Suite Applications (OSA) such as Word Processor, Spreadsheet and Presentation Software is necessary for medical-postgraduate students for their academic and research activities. Our aim was to explore the literacy and self-perceived confidence of the medical-postgraduate students at entry level regarding OSA in a medical college in Delhi.Methodology: A cross-sectional study was conducted among the first-year postgraduate students in a medical college in Delhi using a self-administered, structured and pre-validated questionnaire. A Likert scale was used to assess self-perceived confidence among the students. Responses to questions related to various OSA were scored to identify the literacy score for the application. Mann-Whitney U test was applied to find out significance of the observed differences between the median (IQR) literacy scores of the students regarding OSA based on their self-perceived confidence and previous use of the applications.Results: Median (IQR) literacy scores of the students for Word Processor was 2.0 (2.0- 3.0), Spreadsheet was 1.0 (0.0-2.0) and Presentation Software was 3.0 (2.0-4.0). The difference in the median scores of various OSA was statistically significant (Kruskal Wallis test P value <0.001). Although, majority perceived themselves to be confident about the use of Word Processor and Presentation Software, there was no significant difference in their median (IQR) scores over the students who reported themselves to be unconfident about those two OSA.Conclusion: Training medical postgraduate students to use the OSA and boost their self-perceived confidence in using them is required.
Recreational Spaces in a Village in Central India – An Evaluation through “Transect Walk”
Authors: Singh A. J. , Giri M. Y. , Raut A. , Sophiya K. , Dambhare D. , Jakasania A.
Published: July 2023

No abstract available
IL MAGISTRATO DI SANITÀ DELLO STATO DI MILANO (1534-1786) E LE SUE POLITICHE SANITARIE
Authors: Antonielli Livio
Published: July 2023

The purpose of this article is to explain how the State of Milan protected itself from epidemics (particularly the plague) and epizootics in the 17th and 18th centuries. The Magistrate of Health (Magistrato di Sanità), which operated from 1534 to 1786, was the organization in charge of this responsibility. The primary objective is to study this magistrature's internal structure, authority, and capacity of involving local communities in preventative action. The second goal is to outline how this magistracy was able to swiftly establish strict sanitary cordons that, despite the era's limited scientific understanding, partially protected the State of Milan from epidemics and epizootics.
DANTE E LA LOMBARDIA
Authors: Spera Francesco
Published: July 2023

The essay is divided into two parts. The first deals with the presence of Lombardy in Dante Alighieri’s Divine Comedy. Some characters of Lombard origin are analyzed and also the allusions to the Lombard capital, Milan. We come to the conclusion that the characters, the cities, the Lombard principalities have a lot of prominence in Dante’s work. The author sees in this region a multiplicity of civil, cultural and political experiences far superior to other Italian regions (even if Tuscany and Florence have a more relevant presence). The second part briefly investigates the fact that the renewed interest in Dante originates in the early nineteenth century in Milan, where several editions of his works are printed and comments and studies are developed. It is also important to point out that the interpretation of Dante as the first and greatest Italian writer must be framed in the Italian culture of the first decades of the nineteenth century, when romantic poetics arrived in Italy and at the same time the ideas of the Risorgimento spread, so much so that we trace in those same decades Dantesque influences also in the creative works of writers and artists from the Lombardy area.
A comparative study of endoscopic tympanoplasty versus microscopic tympanoplasty in simple chronic otitis media
Authors: Li Jun-Liang , Chang Kuang-Hsi , Chang Hung-Min , Li Anthony , Ko Min-Cheng , Tsai Stella Chin-Shaw
Published: July 2023

Background:

Otologic surgeries previously used microscopes, requiring large incisions. Recent advances in medical optical resolutiosn allows the introduction of the otologic endoscope as a less invasive alternative, providing better visualization and accessibility. Endoscopic surgery is now preferred for type 1 tympanoplasty and cholesteatoma treatment.

Objectives:

This study aims to compare the outcomes between patients who underwent endoscopic tympanoplasty and those who underwent microscopic tympanoplasty without ossiculoplasty or mastoidectomy.

Methods:

We retrospectively examined the data of 191 patients (201 ears) who underwent tympanoplasty without ossiculoplasty or mastoidectomy using either an endoscope or a microscope in the Department of Otolaryngology, Tungs’ Taichung MetroHarbor Hospital, Taichung, Taiwan, from July 1, 2014 to June 30, 2019. We compared the surgical and functional outcomes between the two approaches. We also analyzed the relationship between the two approaches and the size of the perforated tympanic membrane.

Results:

Endoscopic and microscopic tympanoplasties were performed in 67 and 134 ears, respectively. The preoperative pure tone average or air-bone gap values between the two groups were not statistically significant. The tympanic membrane healing rates for the four subgroups were classified according to the perforation size (Q1 : ≤ 25%, Q2 : > 25% & ≤ 50%, Q3 : > 50% & ≤ 75%, and Q4 : > 75% & ≤ 100%) were 90.9%, 94.1%, 95.0%, and 87.5% (P = 0.893), respectively, for the endoscopic group, and 97.0%, 86.4%, 97.1%, and 72.7% (P = 0.011), respectively, for the microscopic group. The postoperative improvement in the air-bone gap and pure tone average values between the two groups was not statistically significant. When considering the perforation size, the improvement in air-bone gap values was significantly different among the endoscopic groups (−1.0, −11.1, −3.9, and −7.8 dB, P = 0.002 for Q1, Q2, Q3 and Q4, respectively). Additionally, the procedure was markedly shorter in cases that underwent endoscopic surgeries for tympanic membrane perforation size of <25% (P = 0.007).

Conclusion:

Patients who underwent endoscopic and microscopic tympanoplasties without ossiculoplasty or mastoidectomy showed similar surgical and functional outcomes. Moreover, the procedural duration was markedly shortened in cases that underwent endoscopic surgeries, especially for those with small-sized perforations of the tympanic membrane.
Refractory headache: New knowledge review
Authors: Liao Da-Ming , Chen Chieh
Published: July 2023

Most cases of intractable headaches are primary and functional in nature, and secondary headaches due to subarachnoid hemorrhage are not included in this category. Primary headache can be divided into the following two types: migraine and chronic tension-type headache. Moreover, if it is a chronic tension-type or an intractable headache, it is referred to as a refractory headache, which is more common in the elderly. This article aimed to describe the clinical differential diagnosis of intractable headache, latest management methods, risk factors associated with headaches, and other possible treatment options.
Slippage of an Undeployed Stent in the Left Main Artery
Authors: Abdelaziz Abdelaziz Ahmed , Taleb Ahmed Maher Abo
Published: July 2023

Advances in stent design and technology have made stent loss during percutaneous coronary interventions rare. When an undeployed stent dislodges in the left main (LM) artery during percutaneous coronary angioplasty, the risk of life-threatening procedural complications is high. We report a 50-year-old male patient, a smoker, with a history of diabetes mellitus and hypertension with typical chest pain on minimal exertion. Electrocardiogram and echo revealed ischemic changes and regional wall motion abnormality. Culotte technique was used. A new 3 mm × 48 mm stent was inserted in the LM-left circumflex (LM-LCX) followed by stenting of the LM-left anterior descending (LM-LAD) ostia with a 3.5 mm × 18 mm stent. The two balloons were rewired and kissed. Stent slippage and dislodging in the LM artery can be corrected using the culotte technique to crush the undeployed stent behind the LM-LCX and LM-LAD stents.
Anesthesia and Pulmonary Hypertension: A Narrative Review
Authors: Çekmen Nedim , Gökdemir Begüm Nemika
Published: July 2023

Pulmonary hypertension (PH) is a complex disease of the cardiopulmonary system. Perioperative management of PH is one of the most challenging issues for the anesthetists. Morbidity and mortality are significantly high in PH patients undergoing surgery due to right heart failure, arrhythmia, atrial fibrillation, ischemia, hemodynamic unstability, hypoxia, respiratory failure, renal failure, sepsis, and stroke. In PH patients, it is important that more than one physician, including anesthesiologist, intensivist, pulmonologist, cardiologist, and surgeon, discuss the patient’s possible difficulties and complications with a multidisciplinary approach and make a decision. In order to optimize the management of PH patients, it is necessary to comprehensively evaluate the underlying cause, pathophysiology, risk factors, course, and treatment of the disease. A balanced anesthesia technique, including inhalation or intravenous agents, appropriate regional anesthesia (RA), opioids, and α-2-adrenoceptor agonists, may provide the most uniform hemodynamic profile in these patients. The basis of anesthesia management should be to prevent and treat triggering factors, provide perfusion pressures, and optimize right ventricular functions. Advanced monitoring, pulmonary vasodilator therapies, adequate anesthesia and analgesia, and appropriate ventilator settings should be performed for patients with PH. Patients with PH should be followed in the intensive care unit in the first 48–72 h postoperatively. Our review aims to focus on appropriate preoperative preparation, perioperative monitoring, anesthesia and ventilator management, pain control, preventive methods, and treatment in patients with PH in light of the literature.
Hemangiopericytoma of the skull base: A long-term complete response with trimodality treatment
Authors: Bolukbas Meltem K. , Akovali Emine S. , Musri Fatma Y. , Demirtas Rabia
Published: July 2023

Hemangiopericytoma (HPC) is a rare tumor originating from Zimmerman pericytes. It constitutes less than 1% of all intracranial tumors. Because of the high recurrence rates, radiotherapy (RT) is a vital step in the treatment, but the timing and dose remain uncertain. We presented a 39-year-old patient with a high-grade hemangiopericytoma located at the skull base. The patient presented with a severe headache. Cranial magnetic resonance imaging (MRI) revealed a mass of size of 60 × 50 mm. A subtotal resection was performed that confirmed the diagnosis of HPC. The patient received 66 Gy postoperative RT. Adjuvant sunitinib treatment was initiated after RT. The complete regression was achieved in the third month after RT. The patient has a complete response for 25 months. To our knowledge, this case is one of the rare cases in the literature in which immediate RT and adjuvant chemotherapy were used in combination with surgery. Although HPC is a radio- and chemo-resistant disease, a trimodality treatment approach can provide the patients with a complete response. In particular, patients with high-grade and inoperable tumors and patients who undergo subtotal resection should be evaluated for trimodal therapy.
Surgical site infection in Nigerian patients
Authors: Enweluzo George Okwudilichukwu , Akinmokun Olasode I. , Alabi Eyitayo O. , Ohadugha Adaugo G. U. , Giwa S. O.
Published: July 2023

Background:

Infection remains an important complication of surgical procedures. It is an important aspect of patient care as it can be a source of distress for the patients, and the healthcare system in terms of finance and psychological impact. The administration of appropriate prophylactic antibiotics is important in the prevention of surgical site infection (SSI). However, resistance to antibiotics by the micro-organisms is a growing concern in the healthcare industry. This study compared the infection rate between Ceftriaxone and Ceftriaxone-Tazobactam combination as surgical prophylaxis in Nigerian population.

Method:

This was a double blinded randomized study conducted at the Lagos University Teaching Hospital from October 2020 to September2021. Two hundred and forty (240) patients, who were to have surgical procedures performed on them, were recruited and randomly distributed into two groups (A&B) of 120 patients each. Group A were those who had Ceftriaxone alone, while group B were those who had combination of Ceftriaxone and Tazobactam.

Results:

There was no statistical difference in the demographic characteristics of the two groups. The crude infection rate was 3 .8 %. The infection rate in group A was 3 .3 % within the first week but increased to 4 .2 % in the second week. The infection rate in group B was 3 .3 % within the first week and second week. At 30 days, the infection rate within group A was 2 .5 % and 0 % in group B. Regression analysis showed advanced age (P =0 .003), level of education (P =0 .0001),prolonged duration of surgery (P =0 .012) and excessive blood loss (P =0 .0001) as the important factors associated with development of SSI in the patients included in the study.

Conclusion:

Surgical site infection remains an important complication following surgeries. Certain factors such as advanced age, prolonged surgery and excessive blood loss increase the risk for SSI. Efforts should be geared towards prevention of SSI in patients by modifying risk factors that are modifiable and using antibiotics with better infection rate as prophylaxis.
The prevalence of impaired fasting glucose, undiagnosed diabetes mellitus, and associated risk factors among adults presented in the outpatient department in Mogadishu Somalia
Authors: Bashir Ahmed Muhammad , Fiidow Osman Abubakar , Mohamud Ahmed Adam
Published: July 2023

Background:

Diabetes is a major health concern that has grown to alarming proportions. With more than 500 million sufferers globally, diabetes is one of the most prevalent metabolic diseases. The aim of the study is to find the prevalence of impaired fasting glucose (IFG) and undiagnosed diabetes mellitus (DM) in patients presented to our outpatient department at Mogadishu Somali Turkey Training and Research Hospital.

Methods:

In this cross-sectional study conducted in the largest referral hospital in Mogadishu Somalia, all adult patients who volunteered to give consent have participated in the study. We excluded pregnant women, individuals taking medications that could affect glucose metabolism (e.g., steroids, beta-blockers, and thiazide diuretics), and confirmed diabetic patients from our study.

Results:

Seven hundred and twenty-two adults with a mean age of 42.85 ± 18.23 years were included. Most of the participants were female 432 (59.8%), aged 20–40 years 329 (45.6%). The prevalence of IFG was common among males (22.4%) and those 60 years and above (30.6%), while the prevalence of undiagnosed DM was high among males (9.7%), aged 40–60 years (13.4%). In the bivariate analysis, total cholesterol, high-density lipoprotein, triglycerides, systolic blood pressure, and comorbidities were found to be significantly associated with the prevalence of IFG in all age groups.

Conclusions:

IFG was common among outpatient adults. Increased urbanization, the rise of the middle class, and population aging will lead to considerable rises in IFG, undiagnosed diabetes, and diabetes in Somalia in the next years. To limit the growth of diabetes in Somalia, public health interventions must be implemented soon. Promoting the health system and providing education can help.
Fall risks and Health-related quality of life among elderly attending primary healthcare centers in South Western Nigeria
Authors: Akodu Babatunde , Okonkwo Cynthia , Balogun Mobolanle , Alabi Eyitayo , Iloh Gabiel , Olokodana-Adesalu Olufunmilayo , Orumbie Patrick , Oghide Oziegbe , Ojikutu Moniola , Agunbiade Hussein
Published: July 2023

Background:

The older persons are prone to falls resulting in severe injury. Falls among the older adults lead to significant public health sequelae and they account for the most prevalent forms of accidents that occur in older persons. Fall risks may be higher among the elderly with poor quality of life. This study was aimed at evaluating fall risks and the quality of life of the older adults attending primary health-care (PHC) centers in Lagos.

Methods:

This was a descriptive, cross-sectional study carried out among the elderly that attended PHC centers in Mushin local government area (LGA), Lagos state. A multistage random sampling technique was used to select the LGA and the PHC centers that were used. Fall Risk for Older People-Community Setting and the short form-12 Health survey were used. A total of 200 respondents from the PHC centers participated in the study. Data were collected and analyzed using Epi-info version 7.2.1.0 software. Associations between fall risks, fall prevalence, and quality of life were determined using Chi-square. The level of significance was set at P < 0.05.

Results:

The prevalence of falls was 15% and 92.5% of the respondents had a low risk of falling and 93.4% had a good quality of life. There was a statistically significant association between risk factors for falls and quality of life (<0.001), as well as the prevalence of falls (<0.001). Those with poor quality of life and those who have fallen previously have a higher risk of falling.

Conclusion:

Fall risk was low, while fall prevalence and quality of life were high.
The correlation between vitamin B12 and folate levels and bone mineral density among the Saudi population in a primary care setting
Authors: Hussain Sarah I Bin , AlKhenizan Abdullah , Mahmoud Ahmed , Qashlaq Hussain
Published: July 2023

ABSTRACT

Purpose:

Bone health and osteoporosis are significant health problems in Saudi Arabia. Approximately 40%–50% of women and 25%–33% of men sustain osteoporotic fractures in their lifetimes. Hence, identifying the risk factors for osteoporosis is crucial in reducing the incidence of fractures.

Materials and Methods:

We retrospectively reviewed the electronic medical records of 557 patients (female 60%, male 40%) aged ≥18 years (mean age, 66.53 years [standard deviation ± 14.169]) who underwent bone mineral density (BMD) scans at the Department of Family Medicine & Polyclinics, King Faisal Specialist Hospital and Research Centre (KFSH&RC) between January 2004 and June 2019. Data collected included demographics, BMD values, vitamin B12 levels, and folate levels.

Results:

This study indicated that the prevalence rates of vitamin B12 and folate deficiencies among the study population were 8.4% and 1.3%, respectively. There was a statistically significant association between vitamin B12 levels and fracture risk (P =0.044). However, no statistically significant correlation was observed between BMD at either site (lumbar spine or femoral neck) and vitamin B12 (P =0.926.,070) and folate levels (P =.683.,79). BMD showed a significant positive correlation with body mass index at the lumbar spine and femoral neck (P = 0.000). There was no statistically significant association between vitamin B12 levels and the use of metformin (P =.26).

Conclusion:

Vitamin B12 is associated with fracture risk; however, vitamin B12 and folate levels are not correlated to BMD (femoral neck and lumbar spine).
Profile of sharp weapon trauma cases in Jharkhand, India: An autopsy-based report
Authors: Kumari Jyotsna
Published: July 2023

ABSTRACT

Introduction:

Medical injury is a break of the natural continuity of any of the tissue of the living body. Sharp weapons are one of most violent means of death. This study documents the nature of injury among sharp weapon trauma cases and the cause of death among them. Studies also include the prevalence of the most frequently injured part of the body. It has always been a crucial and condemnable method of fatalities, either suicidal or homicidal.

Methods:

It is an autopsy-based study conducted in the department of forensic medicine and toxicology at Rajendra Institute of Medical Sciences (RIMS), Ranchi, for the period of one year from July 1, 2012 to June 30, 2013. The variables considered were gender, age, injury pattern, cause of death, etc.

Results:

This study reports that the frequency of death due to sharp weapons in Ranchi is like some other studies conducted in different states of India. Our study reported that out of 2540 medico-legal deaths, 120 (4.72%) deaths were due to sharp weapons, including 91 (75.83%) males and 29 (24.17%) females.

Conclusion:

The study showed that most of the sharp weapon trauma cases were homicidal in nature which is common in 20–39 years. It is observed that sharp weapon cases were common in urban areas. Sharp weapon injuries may be ante-mortem or post-mortem and may be homicidal, accidental (rare), or fabricated in nature.
Biomarkers and their combination in a prediction of decompensation after an index hospitalization for acute heart failure
Authors: Durak-Nalbantic Azra , Begic Edin , Begic Alden , Dzubur Alen , Lepara Orhan , Baljic Rusmir , Hamzic-Mehmedbasic Aida , Rebic Damir , Hodzic Enisa , Halimic Mirza , Badnjevic Almir
Published: July 2023

ABSTRACT

Introduction:

Heart failure (HF) still remains as one of the most common causes of hospital admission with a high mortality rate.

Aim:

To investigate the possible prognostic role of brain natriuretic peptide (BNP), high-sensitivity (hs) cardiac troponin (cTn) I, cystatin C, and cancer antigen 125 (CA125) in the prediction of decompensation after an index hospitalization and to investigate their possible additive prognostic value.

Patients and Methods:

Two hundred twenty-two patients hospitalized with acute HF were monitored and followed for 18 months.

Results:

BNP at discharge has the highest sensitivity and specificity in the prediction of decompensation. For a cutoff value of 423.3 pg/ml, sensitivity was 64.3% and specificity was 64.5%, with a positive predictive value of 71.6% and an area under the curve (AUC) of 0.69 (P < 0.001). The hazard risk (HR) for decompensation when the discharge BNP was above the cutoff value was 2.18. Cystatin C, at a cutoff value of 1.46 mg/L, had a sensitivity of 57% and specificity of 57.8%, with a positive predictive value of 65.8% and an AUC of 0.59 (P = 0.028). CA125, in the prediction of decompensation in patients with acute heart failure (AHF) and at a cutoff value of 80.5 IU/L, had a sensitivity of 60.5% and specificity of 53.3%, with a positive predictive value of 64.5% and an AUC of 0.59 (P = 0.022). The time till onset of decompensation was significantly shorter in patients with four versus three elevated biomarkers (P = 0.047), with five versus three elevated biomarkers (P = 0.026), and in patients with four versus two elevated biomarkers (P = 0.026). The HR for decompensation in patients with five positive biomarkers was 3.7 (P = 0.001) and in patients with four positive biomarkers was 2.5 (P = 0.014), compared to patients who had fewer positive biomarkers.

Conclusion:

BNP, cystatin C, and CA125 are predictors of decompensation, and their combined usage leads to better prediction of new decompensation.
Nutritional status of reproductive age group women: A community-based study
Authors: Sahu Priyanka C. , Ali Inamdar Ismail Farukh Ali , Purohit Laxmikant , Sahu Ajaykumar C.
Published: July 2023

ABSTRACT

Introduction:

Anemia continues to be a major public health problem worldwide, particularly among females of reproductive age in developing country settings. The prevalence of anemia in South Asia is among the highest in the world, mirroring overall high rates of malnutrition.

Objective:

1) To estimate the prevalence of anemia and undernutrition among reproductive age group females. 2) To study factors associated with anemia and undernutrition among reproductive age group females.

Material and Method:

This was cross-sectional study, which was carried out from June 2011 to December 2012 at Nanded City in Maharashtra state among nonpregnant ever-married women of 15–49 years age with a sample size of 750 selected using probability proportional to size sampling technique. Percentage, Chi-square test, analysis of variance (ANOVA) test, and Student’s t test were used for analyzing the data.

Results:

The prevalence of anemia among reproductive age group women was 554 (73.9%). 20.8% of women were undernourished and 4.1% were obese. There was a significant difference in the hemoglobin percentage of study subjects in relation to their age at marriage, weight, and body mass index (BMI). Mean BMI increases significantly as the age of women and duration of marriage increases.

Conclusion:

Nutritional status has a significant effect on the grade of anemia. Women of reproductive age groups are affected by anemia irrespective of age and parity.
Comparison of depression, anxiety, and stress between public and private university medical students
Authors: Al-khlaiwi Thamir , Habib Syed Shahid , Akram Ashfaq , Al-khliwi Huthayfah , Habib Syed Mohammed
Published: July 2023

ABSTRACT

Context:

Depression, anxiety, and stress are common among medical students because of hectic and heavy studies.

Aim:

This study was carried out to determine the magnitude of the Depression, Anxiety, and Stress Scale (DASS) among undergraduate medical students and its relationship with its causative factors in public and private universities.

Setting and Design:

The study tool was DASS (Depression, Anxiety, Stress Scale-21) which was distributed through the Department of Physiology, College of Medicine, King Saud University, adopting a multistage cluster sampling method for an observational study design.

Subjects and Data:

Data from undergraduate medical students (N = 337) was collected from public and private medical colleges in Saudi Arabia.

Statistical Analysis:

Independent t-tests and analysis of covariance were applied to analyze the data.

Results:

There was a significant difference in depression with a higher mean score in private versus public medical students (8.38±5.93 vs 6.34±5.46, p=0.001), anxiety (9.49±5.12 vs 7.91±5.00, p=0.005), and stress (9.11±5.11 vs 7.93±5.02, p=0.035). There was a significant difference in the level of anxiety between second- and third-years students (p =0.01).

Conclusion:

Private medical university students have significantly higher depression, anxiety, and stress levels compared to public universities. More studies are needed to explore the causes of this psychological impact.
Prospective study on outcome of MDR-TB using the shorter regimen during COVID-19 pandemic
Authors: Kumar G Sravan , Sameena P , Karthik V , Ghanate Nalini
Published: July 2023

ABSTRACT

Background:

According to Indian TB report 2020, 66,225 MDR/RR-TB cases were detected in India, 56,569 (85%) were put on treatment, and 40,397 (75%) were initiated on shorter drug regimens at the time of diagnosis. In the absence of an effective vaccine, there is an urgent need for new treatment regimens, drugs, and diagnostics to slow the evolution of drug resistance and limit transmission of resistant variants, as well as to ameliorate the treatment outcome of patients infected with MDR/XDR M. tuberculosis strains.

Aim:

To evaluate the efficacy of a shorter drug regimen in MDR-PTB and estimate the adverse effects of drugs used in the regimen.

Methods:

This is an institution-based prospective study which included 135 confirmed MDR-PTB patients. Patients with extra-pulmonary MDR-TB and use of SLI for more than one month were excluded.

Results:

The success rate using a shorter regimen was 65.2% which is respectable, given the COVID-19 pandemic considered during the study period. Minor adverse events such as nausea (39.3%) and vomiting (34.8%) were reported. Rare adverse effects such as hearing loss (8.9%) and hypothyroidism (0.2%) were also seen in the study population.

Conclusion:

Overall treatment success was similar when compared to other studies done previously. A shorter drug regimen was associated with minor adverse effects such as gastrointestinal adverse effects such as vomiting and hearing loss observed in elderly patients. Baseline unknown drug resistance and lower BMI were associated with unsuccessful outcomes. Measures should be taken to improve nutrition. Our results argue the need for improving baseline DST at peripheral areas in order to effectively evaluate resistance to other drugs, especially in settings with high levels of first and second-line drug resistance.
Public perception of common cancer misconceptions: A nationwide cross-sectional survey and analysis of over 3500 participants in Saudi Arabia
Authors: Marouf Azmi , Tayeb Rama , Alshehri Ghady D. , Fatani Hana Z. , Nassif Mohammed O. , Farsi Ali H. , Akeel Nouf Y. , Saleem Abdulaziz M. , Samkari Ali A. , Trabulsi Nora H.
Published: July 2023

ABSTRACT

Purpose/Background:

Patients and healthcare providers use online health information and social media (SM) platforms to seek medical information. As the incidence of cancer rises, the popularity of SM platforms has yielded widespread dissemination of incorrect or misleading information about it. In this study, we aimed to assess public knowledge about incorrect cancer information and how they perceive such information in Saudi Arabia.

Methods:

A nationwide survey was distributed in Saudi Arabia. The survey included questions on demographics, SM platform usage, and common misleading and incorrect cancer information.

Results:

The sample (N = 3509, mean age 28.7 years) consisted of 70% females and 92.6% Saudi nationals. Most participants had no chronic illness. One-third were college graduates and less than one-quarter were unemployed.

Conclusions:

Differences in level of knowledge about cancer emerged in association with different demographic factors. Public trust in health information on SM also led to being misinformed about cancer, independent from educational level and other factors. Efforts should be made to rapidly correct this misinformation.