bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and determinants of depression among a community people during the COVID-19 pandemic
Authors: Ekong Josephine , Sanni Felix Olaniyi , Paul Abiodun Olaiya , Dada Michael Olugbamila , Faith Ajani Olumide , Afelumo Olaide Lateef , Ariyo Abimbola Oluseyi , Oluwakemi Salami Aisha , Eric Yila , Adeiye Ajani Love
Published: December 2023

Background:

In situations beyond their control, individuals often exhibit feelings of despair and diminished motivation, leading to the onset of depression. Consequently, this study seeks to investigate the occurrence and factors influencing depression among the population of St. Kitts and Nevis amid the COVID-19 pandemic.

Materials and Methods:

This research study utilized quantitative methods through structured questionnaires distributed via a self-administered online survey using a cross-sectional approach. Sampling encompassed a combination of purposive and snowballing techniques, culminating in a participant pool of 397 individuals. The analysis of data was performed using IBM-SPSS version 25.0.

Result:

The prevalence of depression overall stood at 65.5%. Female respondents exhibited 2.18 times higher odds of experiencing depression compared to males, while individuals aged 30 to 39 had a 2.80 times higher likelihood of developing depression compared to other age groups. Those earning between 2000 and 5000 had a 2.28 times higher probability of experiencing depression compared to individuals in different income brackets. Moreover, civil servants showed a 3.66 times higher likelihood of experiencing depression, and individuals whose businesses were forcibly closed faced an 18.91 times higher chance of developing depression. Respondents whose lives were significantly impacted by the pandemic exhibited a 4.48 times higher tendency to face mental health challenges compared to those affected differently by COVID-19 consequences. Additionally, 66.1% of respondents believed life should resume normalcy despite the escalating virus cases, based on their perceptions of COVID-19 preventive measures.

Conclusion:

The government must implement sufficient measures aimed at mitigating the pandemic’s effects to lessen the prevalence of depression.
Skill retention efficacy of conventional versus modified Peyton's four-step intravenous access skill training approach
Authors: Kulkarni Sadhana S , Nayak Prabha P , Sasturkar Vasanti M , Tayade Deepak N
Published: December 2023

Background:

Limited research has explored the impact of skill laboratory (lab) training on skill retention.

Aims:

This study aimed to assess and compare the effectiveness of skill retention between the modified Peyton’s four-step (MPFS) skill lab training approach and the conventional approach (CA) for intravenous (I.V.) access. This research employed a randomized controlled study design conducted within the Skill Development Unit of a Private Medical College and Hospital.

Materials and Methods:

Fifty-eight first-year medical students were randomly allocated into two groups. These groups received the MPFS or CA approach in small-sized skill lab training sessions focusing on I.V. access. The teacher-to-student ratio was maintained at 1:8, and the duration of each skill session was meticulously documented. Student performance was video recorded right after the teaching session and again at 3 months. The evaluation of skill effectiveness on both occasions was conducted by an impartial faculty member using a binary checklist. Additionally, feedback from both students and faculty members was collected. Group characteristics were analyzed using the chi-square test, and the outcomes of the groups were compared with the Student t test. A P < 0.05 was deemed to be of statistical significance.

Results:

The MPFS group consistently achieved significantly higher scores and had more proficient students during both assessment times (12 and 13) compared to the CA group, which had lower scores at both time points (3 and 4). Notably, there was no decline in skill proficiency within either group at the 3-month mark. The CA group expressed their appreciation for the chance to demonstrate independent performance, while the MPFS group placed value on receiving feedback and undergoing repeated observations. It is worth noting that both training approaches were manageable for faculty; however, the MPFS approach necessitated more time compared to the CA approach.

Conclusion:

The MPFS approach outperformed the CA method in acquiring I.V. access skills immediately after training and at the 3-month follow-up.
Quality of life of carcinoma cervix patients attending tertiary care hospital: A cross-sectional study
Authors: Tiwari Harish C , Aditya Vani , Mishra Richa , Khan Imran A
Published: December 2023

Background:

In 2012, cervical cancer became the leading cause of cancer-related deaths among women in India, with an estimated 123,000 new cases and 67,477 reported fatalities. Besides its considerable impact on mortality rates, cervical cancer also results in long-term disability, leading to a loss of productive years. Despite the development of various diagnostic and treatment approaches for cervical cancer, survivors still face significant morbidity, which significantly impacts their quality of life (QOL). The primary objective of this study is to assess the QOL of cervical cancer patients to identify and address issues within the current healthcare system.

Objective:

To investigate the QOL of cervical cancer patients as per the stage of their disease and the type of therapy they receive.

Materials and Methods:

A cross-sectional study was conducted between January 2023 and August 2023. During this period, patients who visited the Department of Obstetrics and Gynecology and agreed to take part in the study were included in interviews. The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire for cervical cancer (EORTC QLQ CX24) was employed to assess the QOL of cervical cancer patients.

Results:

The participants had an average age of 52.4 years, with a standard deviation of 10.5. Most were diagnosed at advanced disease stages (III and IV), while only approximately one-fourth were at stage I. The predominant treatment modality administered was radiotherapy, followed by surgery and chemotherapy. When examining the QOL, it was observed that individuals at stages I and II of the disease tended to experience more significant concerns related to body image and sexual worries. Additionally, patients in stages I and II and those receiving chemotherapy reported higher scores in terms of sexual activity and sexual enjoyment, indicating a better QOL in these aspects.

Conclusion:

As the disease stage progressed, there was a decline in QOL. In the early stages of the disease, QOL related to body image and sexual worries was notably lower. In contrast, QOL about sexual activity and sexual enjoyment was comparatively better for these patients. Patients who received chemotherapy or a combination of treatment modalities reported poorer QOL.
Initiating kangaroo mother care in urban slums: a pilot intervention
Authors: Palaha Harvinder , Singh Iqbal , Pathak Sweety
Published: December 2023

Objective:

Launching the introduction of kangaroo mother care (KMC) for low birth weight (LBW) babies in designated slum communities within the Bhiwandi Nizampur City Municipal Corporation region, and documenting the effects of this program on critical indicators such as the percentage of mothers embracing KMC, the average length of KMC, the early initiation of breastfeeding, and the encouragement of exclusive breastfeeding.

Materials and Methods:

In the slum area of Bhiwandi, situated in the Thane district under the Mumbai Metropolitan Region Development Authority, we selected 1000 households. We identified LBW babies who born in this locality, and our field team conducted home visits. During these visits, families and mothers were guided on administering in-home care to these infants, emphasizing KMC. Subsequently, we monitored these infants for factors such as weight gain, breastfeeding initiation, the adoption of KMC, and the duration of KMC provided.

Results:

As of December 2021, we identified 100 instances of LBW infants. Of these, 95% received KMC, 46% received KMC for 6 h, and 42% received KMC for durations between 6 and 12 h. A total of 67% of these infants showed improvements in their weight. For 66% of the infants, breastfeeding was initiated within the first hour, and 69% were exclusively breastfed for the initial 6 months of life.

Conclusion:

The results highlight the significant potential for improving the adoption of KMC by maintaining regular home visits, delivering guidance to families and mothers, and ensuring continuous care for LBW infants. In addition, this approach contributes to a greater likelihood of early breastfeeding initiation and elevated exclusive breastfeeding rates.
Knowledge and perception regarding the risk associated with self-medication in Ado-Odo Ota local government area of Ogun State, Nigeria
Authors: Shire Qali Hashi , Sanni Felix Olaniyi , Tomori Michael Olabode
Published: December 2023

Background:

Self-medication, extensively adopted globally, has become a widespread practice that raises public health concerns due to its associated consequences.

Materials and Methods:

The study employed a descriptive cross-sectional design within the Ado-Odo Ota local government area (LGA) of Ogun State. A structured questionnaire was administered to gauge residents’ understanding and viewpoints regarding the risks linked to self-medication. The research encompassed all chosen individuals residing in the Ado-Odo Ota LGA, employing stratified random sampling methods to select 240 participants. Data analysis was conducted using the SPSS statistical software package.

Results:

The study revealed that a significant portion of the participants (78%) engaged in self-medication. The primary source of information for self-medication was previous prescriptions (40.2%), indicating that individuals relied on their past experiences and prescriptions for guidance. Interestingly, most respondents, both those who self-medicated and those who did not, considered self-medication unfavorable (61.2% and 67.8%, respectively). Non-self-medicated individuals showed greater awareness of the potential risk of self-medication leading to drug abuse (76.3%) compared with those who self-medicated (62.4%). Moreover, a higher percentage of non-self-medicated individuals (57.6%) believed that self-medication could result in adverse drug reactions compared with self-medicated individuals (23.4%). The study indicated that most respondents had a negative perception of the risks associated with self-medication, with an average score of 2.01 ± 0.87. In addition, most respondents (94.4%) reported getting well after taking the drugs they self-medicated with.

Conclusion:

Measures need to be implemented to enhance public awareness regarding the dangers associated with self-medication, advocate for responsible medication practices, and prompt individuals to seek professional medical guidance for their healthcare requirements.
Clinical and histopathological study of cutaneous lichen planus in a tertiary care center of central India
Authors: Wankhade Suvidhi , Dosi Shilpi , Bansal Shruti , Varma Amit
Published: December 2023

Background:

Lichen planus (LP) is an idiopathic, chronic inflammatory disease of the skin, mucous membrane, and nails. Worldwide distribution is seen, with 0.38% of the lesions prevalent in India.

Objective:

The present study was conducted to study the demographic profiles (such as age and gender) and histopathology of LP and their clinical presentation.

Materials and Methods:

The present study was conducted in the Department of Pathology at Sri Aurobindo Medical College and Post Graduate Institute, Indore. All cases presenting with LP and undergoing skin biopsy from December 2018 to May 2021 were included in the study. Detailed clinical history was taken, and histomorphological evaluation was performed for all the included cases.

Results:

A total of 155 cases of LP were analyzed. The mean age of presentation was 34.89 ± 16.02 years, with slight male predominance. The mean duration of the disease was 7.82 ± 5.34 months. Clinically, most cases presented with mild to moderate pruritis (64.51%), followed by intense pruritis (25.16%). Violaceous papules and plaques were the predominant findings in 80.64% of patients, followed by hyperpigmented papules and macules (13.54%). Histomorphologically, hyperkeratosis was observed in almost all cases (99.35%), followed by wedge-shaped hypergranulosis (65.80%). The most common variant found was classic LP (30.96%), followed by hypertrophic LP (29.6%) and LP pigmentosus (26.4%). Clinicopathological discordance was seen in ~14 (10%) cases.

Conclusion:

Detailed history, clinical examination, and careful histological assessment help diagnose LP and differentiate its variants.
Risk perception and barriers to utilization of mammogram for breast cancer screening among female healthcare professionals in a tertiary health institution, Benin City, Nigeria
Authors: Akaba Felicia Bosede , Osunde Ngozi Rosemary , Olorunfemi Olaolorunpo
Published: December 2023

Background:

For the effective functioning of health workers as promoters of breast cancer prevention through early detection, the need for relevant knowledge about the disease and its early detection is crucial.

Objective:

This study assessed the risk perceptions and barriers to use mammograms for breast cancer screening among female healthcare professionals in a tertiary health institution in Benin City, Nigeria.

Materials and Methods:

The quantitative approach was utilized in this study as it is a systematic process that helps to describe and test relationships among variables without bias. In line with this, a descriptive cross-sectional study was conducted with a sample of 255 female healthcare professionals from April 2023 to July 2023, using the multistage and convenience sampling method. A structured questionnaire was used to collect data with a reliability of 0.781. Data were analyzed using Statistical Package for Social Science (SPSS) version 22.0 and presented in words and frequency distribution tables. Hypotheses were tested with chi-square at a 5% level of significance.

Results:

A total of 225 nurses (88.2%) and 30 doctors (11.8%) participated in the study. The mean age was 45.69 ± 5.814 years (nurses = 45.55 ± 5.679 years; doctors 46.73 ± 6.757 years). Overall, 223 (87.5%) showed a positive risk perception of breast cancer with a mean of 2.74 ± 0.966. Only 35 (13.7%) respondents had a mammogram in the last 24 months before the study. Mean ± SD = 1.15 ±.376. Utilization was not associated with risk perception (P = 0.409), but there was a significant difference (P = 0.001) in the utilization of mammograms between nurses (10.7%) and doctors (36.7%). Perceived barriers to utilization of mammogram include cost 190 (86.4%), preference for other screening methods 210 (95.5%), fear of abnormal findings 189 (85.9%), and busy work schedule 200 (90.9%).

Conclusion:

There is a high positive risk perception of breast cancer but poor utilization of mammography. Therefore, it is recommended to sensitize female healthcare professionals on the need for mammography breast screening through training and re-training.
Returning to sports after frontal sinus fracture
Authors: Aziz Mohamad Azwan , Hussein Kamarul Hashimy , Nahar Azmi Mohamed
Published: December 2023

There is lacking literature on return to sports following a frontal sinus fracture. Poor management of such injury could lead to chronic headache, sinusitis, development of mucocele and meningitis. To the authors’ knowledge, this is the first case report that describes the concise and successful return to play (RTP) in an athlete who suffered from a frontal sinus fracture with a concussion, using the latest guideline, Sport Concussion Office Assessment Tool 6. This is a case of a hockey player who had a direct blow to the head and sustained an anterior wall frontal sinus fracture, confirmed by a computed tomography scan. The difference in strategy of RTP in this condition, from a typical concussion, is to allow fracture healing to take place. Our article described in detail how such athlete is managed and what complication should be observed in such athletes.
Exploring the perception of dietary supplement intake amongst gym users in Klang Valley, Malaysia
Authors: Hasim Muhamad Hishamudin Mohmad , Lim Christopher Thiam Seong , Lim Yin Sze , Cheng Shi-Hui
Published: December 2023

Background:

Gym users are one of the populations who frequently consume dietary supplements. Nevertheless, data investigating the perspective of gym users regarding dietary supplement intake are still lacking. Our qualitative study aims to acquire insights into the perceptions of gym users regarding dietary supplement consumption.

Methods:

A total of 10 gym users who have a membership and are actively training at the gymnasium were recruited from Selangor and Kuala Lumpur, Malaysia. In-depth interview was conducted, and all responses were recorded and transcribed verbatim. The data were analysed using the NVivo version 12 software.

Results:

All participants consume dietary supplements almost every day, with most of them taking at least three supplements a day. Five themes emerged from these interviews: (1) gym and the use of dietary supplements, (2) reasons for supplement intake, (3) source of information, (4) supplement perceptions and beliefs and (5) health screening experience. Half of the participants did not consult with any nutritionist or dietitian before taking dietary supplements. The reasons for consuming supplements are to improve muscle mass, enhance performance, maintain overall health, fasten recovery time and prepare for competition. Our findings suggest that participants perceived supplements to be beneficial and exceeded the potential adverse effects.

Conclusions:

Lack of awareness amongst the recruited gym users in Klang Valley, Malaysia, regarding the potential risk of side effects suggests that there is a need to provide correct information about the benefits and risks of using dietary supplements.
Relationship between music genre and the ‘flow state’ during training amongst gym-goers
Authors: Dass Jonathan D. , Fatt Ong Tah , Ong Wen Bin
Published: December 2023

Background:

Music has been shown to affect a person’s ability to achieve flow state during exercise. However, it depends also on the selection of the right music for the exercise and the person in question.

Aims and Objectives:

The present study aims to examine the relationship between the ‘flow state’ of gym-goer’s training and the music genre gym-goers listen to during training.

Materials and Methods:

Data were collected from a sample of 167 gym-goers from different gyms in the Petaling Jaya (PJ) area, utilizing a purposive sampling technique.

Results:

The results revealed that the most preferred genre of music listened to while training, across all genders, ages, and types of training, was ‘Pop’ music (m = 3.6 ± 1.17). In terms of gender, females listen to significantly more ‘Pop’, ‘K Pop’, and ‘Soul’ than males. Pearson correlational analysis reviewed that listening to ‘Hard Rock’ (r = .273, P = .001), ‘Rock’ music (r = .222, P = .004), and Hip Hop (r = .204, P = .008) while training was found to have a significant correlation with experiencing flow state.

Conclusions:

The findings of this study provide gym-goers, gym owners, coaches, and sports psychologists with a comprehensive understanding of the genres of music to listen to or play while training to enhance the quality of training.
Role of hydration status on cognitive functioning in athletes: A scoping review
Authors: Jyoti Ala Naga , Tiwari Keren Harish , Kalpana Kommi
Published: December 2023

The detrimental effects of dehydration on cognitive functioning have been researched; however, definitive conclusions were not extracted. Therefore, the present review aimed to examine the role of hydration status and its influence on cognitive functioning in athletes. Research studies were identified by searching online databases such as PubMed, Google Scholar and ProQuest using the keywords ‘hypohydration’, ‘dehydration’, ‘hydration’, ‘euhydration’, ‘cognition’, ‘cognitive performance’, ‘cognitive functioning’, ‘athletes’ and ‘sportspersons’. A total of 50 original studies were identified, and 24 articles that met the inclusion criteria were examined for the review. A decrease in cognitive functioning was reported in 12 studies with dehydration. This trend was particularly observed when dehydration was coupled with increased exercise duration and/or exercising in a hot environment or high-intensity exercise. Ten studies did not find any impact of dehydration or euhydration on cognitive functioning, and two studies showed increased attention and accuracy in dehydration. Cognitive functioning seems to be unaffected due to dehydration until there is an increased exercise intensity and/or duration in hot and humid conditions. Further studies high in the hierarchy are required to provide definitive conclusions due to limited scientific evidence, heterogeneity in the methodology and non-applicability of outcomes to both genders.
Development of Analytic Rubric for Assessing Written Assignments for Evaluating Higher Order Cognition in the First Phase Neuroanatomy Module
Authors: Rani Anita , Gupta Sarika , Sehgal Garima , Singhal Rameshwari
Published: December 2023

Background:

Competency-based medical education has been recently launched for MBBS students in India by the National Medical Council. Successful implementation of the new curriculum requires not only concrete evidence of acquisition of competencies but also proper feedback to students for his growth in the required direction. In the first phase MBBS program, in the neuroanatomy module, frequently students’ ability to correlate patients’ signs and symptoms is asked during examinations to assess higher order cognitive skill. These questions are usually asked in written assessments as short essay responses. Currently, the use of analytic rubrics is limited in medical students’ written assessment. Teachers use their self-developed criteria to grade students for such answers. Analytic rubrics have evidence to improve case writing, presentation, surgical and soft skills. The present study aims to develop an analytic rubric to assess critical thinking abilities in written exams.

Methodology:

The study was carried out at KGMU, Lucknow. After developing the criteria and grading statements, two rounds of modified Delphi method of consensus building were conducted by involving 20 subject experts. The item-level validity index of 0.7 or above was set to retain the descriptors.

Results:

After the two rounds of consensus, an analytic rubric with 7 criteria, each with 3 performance levels as excellent (>75%), satisfactory (50%–75%), and unsatisfactory (<50%), was developed. All criteria and level descriptors were having content validity index above 0.7.

Conclusion:

The developed analytic rubrics with clear expectations will help learners to set their learning goals and faculty to assess their level of achievements more objectively.
Anatomy Teacher’s Perspectives on Using AnaVu: A Novel Low-resource Stereoscopic Projection System for Neuroanatomy Education
Authors: Yohannan Doris George , Oommen Aswathy Maria , Raju Nithin Kadakampallill , Thomas Bejoy , Rajan Jayadevan Enakshy , Govindapillai Umesan Kannavilakom , Harish Pawan , Kapilamoorthy Tirur Raman , Kesavadas Chandrasekharan , Sivaswamy Jayanthi
Published: December 2023

Background:

The authors had earlier studied the utility of stereoscopic projection of neuroanatomic three-dimensional models through AnaVu (a low resource stereoscopic projection system) on medical students. The tool was developed by collaboration between anatomy teachers, radiologists, and visualization experts. Although the preliminary results indicated advantages in learning, the perspective of the anatomy teachers, the end users of the tool, was not known and hence this study.

Methodology:

A cross-sectional study of the observational nature was conducted where Faculty of South Kerala was informed that they will be given an opportunity for a hands-on experience to use AnaVu. A 15-min session was given to each teacher. Their feedbacks were collected using a prevalidated questionnaire tool and open comments were also collected. Analysis was done using the software SPSS and RQDA.

Results:

Thirteen faculty members participated in the study. Quantitative analysis showed that teachers were able to teach (4 ± 0.57), likely to use it for teaching if made available (4 ± 0.71), found it easy to use (3.31 ± 0.48), and realistic to anatomy (3.62 ± 0.87). Qualitative analysis showed general appreciation and advantage in teaching spatial anatomy. Faculty also pointed limitations such as lack of interaction with students, eye strain, and need for training to use the tool.

Conclusion:

The study points to the utility of AnaVu, a low resource tool in teaching spatial anatomy. The study also dealt with the concerns that need to be addressed during the scaling of such a tool for utility in the Indian Anatomy education scenario.
Pedagogical Strategies in Medical Anatomy: A Comprehensive Review
Authors: Pandurangam Gayathri , Gurajala Swathi
Published: December 2023

Human anatomy is not just a subject at the level of basic sciences, but also it forms the foundation of medical and allied health sciences. A thorough understanding of the structure of the human body is crucial for students to diagnose and treat various health conditions. Hence, providing a deep insight into the subject with more hours dedicated to practical sessions was the trend followed in previous times. The reduction of teaching hours for anatomy as a part of curriculum change, the difficulty faced by the students to learn the subject within a short span, and the emphasis on anatomy faculty to make it interesting have led to the adoption of various modern teaching strategies and technology to complete the task. The article intends to discuss the contemporary methods of teaching and learning anatomy, elaborating the wide range of approaches and techniques.
During Virtual Anatomy Sessions, do Educators and Learners Feel More at Ease or Anxious? Revisiting the Covid-19 Lock Down Times
Authors: Shinde Amol Ashok , Patel Dinesh K. , Manvikar Purushottam Rao
Published: December 2023

Background:

The COVID-19 pandemic forced the entire education system to accept online teaching as the only way to complete the stalled MBBS teaching-learning. Later, the hybrid mode of teaching was started in many colleges. This study is a revisit to lockdown times from teacher’s and learner’s points of view to determine the various difficulties faced by teachers and learners during online classes.

Methodology:

In this longitudinal questionnaire-based survey, questionnaires in English were given to 750 MBBS students of 2019–2020, 2020–2021, and 2023–2024 batches and 47 MBBS teachers.

Results:

Sixty-three percent of students strongly agreed to selecting classroom lectures over online classes. Teachers faced technophobia in app-based education (39%) and absence of response while teaching (18%) as difficulties during online classes. Internet connection issues and unfriendly learning management system applications were the issues faced by the students.

Conclusion:

The integration of offline and blended learning can make teaching by teachers and interpretation by students better.
A Study Based on Perception of First Phase Undergraduate Medical Students and Faculty on Integrated Teaching in Anatomy
Authors: Konar Sudipto , Sarkar Sreetama , Mondal Maloy Kumar , Aggarwal Prerana
Published: December 2023

Background:

Integrated teaching has been recognized by the National Medical Commission as an effective method for enhancing knowledge and clinical correlation abilities among undergraduate medical students. This study aimed to assess the perceptions of first-phase undergraduate medical students and faculty toward the vertically integrated teaching–learning sessions in anatomy.

Methodology:

Three sessions of shared integration were conducted in the department of anatomy, involving the departments of surgery and orthopedics. After completion of the sessions, 147 students and 47 faculty members filled out prevalidated questionnaires to assess their perception of the integrated sessions. Feedback from the faculty was also taken. Statistical analysis was done by expressing the responses to the questionnaire on the five-point Likert scale as frequencies.

Results:

More than 85% of the students and faculty found these sessions engaging, interesting, and useful for understanding clinical problems related to anatomy. The students and faculty perceived the knowledge gained during these sessions as beneficial for answering university examination questions and for future clinical phases. However, 66% of the faculty expressed concerns about the time and coordination required for these sessions, and 89% considered arranging them challenging due to limited workforce availability.

Conclusion:

The findings indicate that undergraduate medical students perceive integrated teaching as a practical approach for acquiring anatomical knowledge and correlating it with the clinical aspects of a problem. Faculty members also acknowledged the usefulness of these sessions, but the challenges of regular arrangement were also highlighted. These results emphasize the importance of balancing clinical and anatomical education and provide insights for implementing integrated teaching strategies in the undergraduate medical curriculum.
Prevalence and Distribution of Postvoid Residual Urine Volume in a Hospital-Based Sample of Men with Symptomatic Benign Prostatic Hyperplasia
Authors: Anyimba SK , Amu OC , Nnabugwu II , Okoh AD , Nwachukwu CD , Iwenofu CA
Published: December 2023

Background:

Benign prostatic hyperplasia (BPH) is a known cause of bladder outlet obstruction (BOO) in aging men. Patients present with lower urinary tract symptoms (LUTS), elevated postvoid residual urine (PVR), and reduced peak flow rate of urine. Although urodynamic study is the gold standard for diagnosing and quantifying BOO, it is invasive and as such urologists in their routine practice frequently rely on less invasive methods like PVR estimation to objectively assess BOO.

Aim:

To study the prevalence and distribution of PVR in a hospital-based population of men with symptomatic BPH.

Materials and Methods:

Patients aged 40 years and above were enrolled for the study. History was taken from each of the 170 participants recruited, and physical examination was done including digital rectal examination. Every one of them completed the International Prostate Symptom Score (IPSS) questionnaire and also had ultrasonography assessment of PVR. Relevant laboratory investigations (PSA, renal function test, full blood count, urinalysis, and urine culture) and uroflowmetry to determine the peak flow rate of urine (Qmax) were done.

Results:

A total of 170 subjects who met the inclusion criteria were enrolled for this study. The mean age of the subjects was 63.70 ± 9.92 years with a range of 42–88 years. The subjects had a mean PSA of 2.68 ± 0.91 ng/ml and a mean prostate volume of 70.8 ± 39.5 ml. The prevalence of significant PVR was 57.06%. The distribution of PVR was skewed with values ranging from 4.0 ml to 382.9 ml, a median value of 60.5 ml (interquartile range, IQR, =25.0–100.76), and a mean value of 77.70 ± 69.30 ml. An IPSS range of 8 to 23 with a mean value of 13.64 ± 4.14 and a median value of 13 (interquartile range = 10.0-16.0) was observed. The Qmax range was from 5 ml/s to 50 ml/s with a mean value of 20.25 ± 9.70 ml/s, and a median value of 18.0 ml/s (interquartile range = 14.0–24.0).

Conclusion:

This study showed that the prevalence of significant PVR volume among men with symptomatic BPH in our environment is high. There was also a high variation in the distribution of PVR among the subjects. Therefore, it is essential to create more public awareness especially among men in their fourth decade of life and above to visit a urologist whenever they have BPH symptoms so as to avoid impairment in quality of life and renal function associated with neglected significant PVR.
Percutaneous Radiofrequency Disc Decompression: A Study of 27 Patients
Authors: Živković N , Ruetten S , Tasić G , Janicijević A , Jelena K , Nikola J , Andjelković I , Jovanović S
Published: December 2023

Background:

Percutaneous radiofrequency nucleoplasty is a true minimally invasive technique for treatment for radiculopathy caused by contained disc protrusions. This minimally invasive procedure uses controlled thermoablation for reducing the intervertebral disc and decompressing the lumbar nerve root. Material and Methods: Our study is a prospective analysis of 27 patients aged from 30 to 64 years with lumbar disc protrusion who were treated with percutaneous radiofrequency disc decompression (PRFD) between May 2018 and May 2019. Clinical follow-up was reported at 1 month, 3 months, and 6 months. The outcomes were assessed using a visual analog scale (VAS) and MacNab score.

Results:

Of the 27 patients, 14 were female and 13 were male. Their mean age was 53 ± 2 years. In all 27 patients, percutaneous radiofrequency nucleotomy was performed. An excellent outcome as reflected by MacNab score was observed in 17 patients (63%), a good outcome in 8 patients (29.7%), and a poor outcome in 2 patients (7.3%). Prior to treatment, the average back and leg VAS scores were 7.95 and 7.82, respectively. At sixth month follow-up, the back and leg VAS scores were reduced to 3.17 and 3.04, respectively. Patients with a poor outcome developed early recurrent disc prolapse and required endoscopic discectomy.

Conclusion:

PRFD is a safe and effective treatment of contained disc protrusion. PRFD is a good alternative to surgery. These procedures significantly increase quality of life in patients with lumbar radiculopathy.
Quality and Quantity of Nucleic Acids Extracted from Formalin-Fixed Paraffin-Embedded Lymphoma Biopsies from Nigerian Archived Biopsy
Authors: Uzoma IC , Taiwo IA , Ugwu NI , Durosinmi MA , Akinloye O
Published: December 2023

Background:

Integrity of nucleic acids derived from archived formalin-fixed paraffin-embedded (FFPE) cancer specimens affects diagnosis, prognosis, and therapy. Several factors affect the quality and quantity of extracted nucleic acids and one of such factors is storage period.

Aim:

We investigated the impact of storage duration on the quality and quantity of nucleic acids extracted from archived FFPE lymphoma biopsies in Nigeria.

Materials and Methods:

A total of 53 FFPE biopsies diagnosed as lymphoma stored over several years (2008–2019) were analyzed. They were 22 chronic lymphocytic leukemia (CLL) cases, 17 Hodgkin lymphoma (HL) cases, and 14 diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS). DNA was extracted from all the lymphoma samples which were analyzed for integrity and amplifiability using the four pairs of control genes polymerase chain reaction (PCR) primers of BIOMED-2 protocol, whereas RNA extraction was from 6 CLL cases used for qPCR analysis of RNU43.

Results:

For CLL, the mean DNA yield was 193.6 ng/µl (range: 3.0-533.0 ng/µl), whereas the mean A260/A280 ratio was 1.7 (1.2-1.9). For DLBCL, NOS, and HL, 255.5 ng/µl (range: 32.9-605.4 ng/µl), 1.8 (1.5-2.0) and 242.7 ng/µl (range: 1.3-886.0 ng/µl), and 1.7 (0.9-1.8), respectively. The extracted DNA gave amplifiable products of at least 200bp, whereas the RNA analysis showed CT values of <38 in all the samples. The mean RNA yield was 462.2 ng/µl (range: 74.7-1082.1), whereas the mean A260/A280 was 1.7 (1.5-1.8).

Conclusion:

Quantity and quality of nucleic acids from FFPE tissues stored for different time periods showed no significant difference in yield and quality.
The Relationship between Choroidal Thickness and Liver Damage in Simple Auto-immune Hepatitis Patients
Authors: Song D , Rong Y , Zhang C , Sun Y
Published: December 2023

Background:

There was no sufficient clinical evidence on the relationship between auto-immune hepatitis (AIH) and risk of eye illness, except 11 uveitis cases where related AIH is reported currently.

Aim:

To determine the relationship between choroidal thickness (ChT) and liver damage in simple AIH patients without ocular symptoms after oral prednisone treatment.

Patients and Methods:

This prospective observational study included simple AIH patients. The patients’ ChT was measured by swept-source (SS)-optical coherence tomography (OCT), and the liver damage was evaluated by alanine aminotransferase (ALT) and aspartate aminotransferase (AST). ChT and liver functions were assessed prior to and after treatment. Then comparisons were made prior to and post treatment. The relationships between biochemical indexes of liver injury and ChT were evaluated after a mean (SD) of 24 (1.28) weeks of regular oral prednisone.

Results:

A total of 35 patients (31 females, aged 45.66 ± 11.62 years) were included. After treatment, ChT was significantly increased in all sectors (including the center sector, superior inner sector, inner nasal sector, inferior inner sector, inner temporal sector, superior outer sector, outer nasal sector, inferior outer sector, and outer temporal sector) (all P < 0.001). After treatment, both ALT (51.34 ± 44.16 vs 255.06 ± 107.84, P < 0.001) and AST (38.66 ± 27.12 vs 164.89 ± 85.58, P < 0.001) were significantly decreased. The increase of ChT in all sectors was significantly related to the decrease of ALT and AST (all P < 0.001).

Conclusion:

The improvement of ChT might reflect the remission of liver damage in simple AIH patients without ocular symptoms during oral prednisone treatment.
An Evaluation of the Effect of Using Irrigations at Different Temperatures on Pain, Edema, and Trismus during the Extraction of Bilateral Impacted Mandibular Third Molars: A Randomized Split-Mouth Clinical Trial
Authors: Dayanan C , Ozupek MF , Seyrek NK
Published: December 2023

Background and Aim:

The surgical extraction of impacted wisdom teeth is a standard practice in dentistry. Unfortunately, inflammatory reactions such as discomfort, edema, and trismus frequently jeopardize patients’ well-being after the extraction of third molars. Saline solutions at room temperature (25°C) are routinely used in impacted tooth extraction. Refrigerated saline solutions were used to work with cold solutions, and as the refrigerator temperature was 4°C, this study was designed to have a cold solution temperature of 4°C. This study aimed to assess the influence of saline irrigation at various temperatures (4°C, 25°C) on postoperative edema, pain, and trismus after the extraction of impacted third molars.

Materials and Methods:

Eighteen patients with bilateral symmetrical mandibular impacted third molars were enrolled in this split-mouth, randomized, prospective, double-blind clinical trial. For each patient, one side was irrigated with a saline solution (% 0.9 isotonic sodium chloride) at 4°C (test), and the other side was irrigated with a saline solution at room temperature (25°C) (control). Pain, trismus, and facial edema were noted on the 2nd, 4th, and 7th days. A Mann–Whitney U-test was used to compare pairs, and a Wilcoxon signed-rank test was used to compare groups.

Results:

The two groups had no considerable differences in terms of pain levels and facial edema (P > 0.05). Regarding trismus, the maximum mouth opening for cold irrigation (4°C) was significantly higher than for room temperature irrigation (25°C) across all postoperative periods (P < 0.05).

Conclusion:

Cold irrigation therapy (4°C) exerts beneficial effects more than room temperature (25°C) irrigation on the trismus after impacted mandibular third molar surgery.
Discharge against Medical Advice in Eight Tertiary Hospitals in Nigeria: A Prospective Study
Authors: Anyaehie UE , Ede O , Edomwonyi EO , Ekwedigwe HC , Toluse AM , Muoghalu ON , Okoh N , Dabkana TM , Esan O , Ajiboye LO , Shodipo OM , Anikwe IA
Published: December 2023

Background:

Discharge against medical advice (DAMA) is when a patient decides to leave the hospital without the consent of the treating physician. It poses serious clinical, ethical, and legal challenges to the individual physician as well as the hospital.

Aim:

To determine the prevalence and reasons for DAMA in orthopedic departments of eight tertiary hospitals in Nigeria.

Materials and Methods:

This was a prospective multi-center descriptive study undertaken in eight tertiary Nigerian hospitals. Consecutive patients who requested for DAMA within 1 year of the study and who consented to participate in the study had face-to-face interviews. Data obtained were documented in a questionnaire and analyzed with SPSS version 20.

Results:

The total number of patients studied was 373 with a mean age 34.7 ± 17.5 years. About a quarter of them (25.5%) were between 31 and 40 years. A prevalence rate of 1.9% was found with financial constraint being the predominant reason for DAMA (40.8%). Other reasons include family preference for unorthodox treatment (18.8%) and treatment dissatisfaction (7.0%) among others.

Conclusion:

The study findings indicate a low DAMA rate when compared to previous studies in this region. It also indicates that financial constraints, family preference for unorthodox care, and low educational status are major drivers of DAMA. Deepened health insurance and other measures that can reduce the prevalence of DAMA should be prioritized to improve treatment outcomes.
Return to Community Mental Health Centers after the Pandemic: A Qualitative Study on Turkish Patients’ Subjective Experiences
Authors: Türk A , Ünsal E , Engin E , Kayahan B
Published: December 2023

Background:

Community mental health centers (CMHCs) are important institutions for individuals with chronic mental illness. During the COVID-19 period, patients with mental health could not optimally access care in CMHCs.

Aim:

To explore the experiences of patients using a CMHC after its closure due to the COVID-19 pandemic.

Patients and Methods:

This was a descriptive qualitative study that included 16 patients with mental disorders who regularly used CMHCs during the pre-pandemic period. Their data were collected between March 2022 and August 2022 using face-to-face, in-depth semi-structured interviews. All interviews were recorded and the content analysis method was used to analyze the data.

Results:

The age range of the 16 study participants was 29–53 years with a mean age of 40.8 ± 6.5 years. Nine (56.3%) participants were men, and 7 (43.7%) were women. Ten (62.5%) participants had schizophrenia, whereas 6 (37.5%) had bipolar disorder. According to content analysis, the five main themes that emerged based on the statements of participants were the effects of change, difficulties experienced, support needs, coping experiences, and suggestions. The results showed that although patients using CMHCs are struggling with the adverse consequences of the pandemic process, they also have difficulty managing their diseases and daily life due to their inability to access psychosocial services in the CMHCs.

Conclusion:

The patients reported their negative experiences and need for support during the pandemic. The study highlights the need to adequately accommodate mental health services delivery during future pandemics that may impose movement restrictions.
Fixed-drug eruption following first dose of SARS-CoV-2 (COVID-19) vaccine approved for children, an adverse event following immunization
Authors: Amrutiya Marut , Gorasiya Amit , Mistry Ankit , Malhotra Supriya
Published: December 2023

Bullous fixed-drug eruption (FDE) is a rare but potentially severe cutaneous drug reaction that presents with erythema, edema, and bullae formation. FDE lesions are often caused by drugs such as antibiotics, anticonvulsants, and nonsteroidal anti-inflammatory drugs. The diagnosis of FDE is primarily clinical and may be supported by histopathological examination. Treatment for FDE lesions involves immediate discontinuation of the offending drug and supportive care, including topical and systemic corticosteroids. There is growing evidence to suggest that both COVID-19 and its vaccination can induce skin reactions. We report a case of a 14-year-old girl who developed a bullous FDE lesion following an anti-COVID-19 SARS-CoV-2 immunization.
Niraparib in the treatment of ovarian cancer: A comprehensive review
Authors: Sharma Chetan , Badyal Dinesh Kumar
Published: December 2023

Niraparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, has emerged as a promising therapeutic option in the management of ovarian cancer. Ovarian cancer remains a significant global health concern, often diagnosed at an advanced stage with limited treatment options. The PARP inhibitors have revolutionized the therapeutic landscape by exploiting deficiencies in DNA repair pathways, particularly in tumors with homologous recombination deficiencies. Niraparib, a selective PARP-1/2 inhibitor, has shown promising results in various clinical settings, making it a subject of intense research. This review aims to provide a comprehensive overview of the current state of knowledge regarding the efficacy, safety, and clinical implications of niraparib in the treatment of ovarian cancer.
Manual small incision cataract surgery in bilateral pediatric cataracts in rural population
Authors: Ramani Soumya , Ksheeraja Y. , Deepthi R. H. , Pius Chris Diana
Published: December 2023

The main purpose of this study is to describe the visual outcomes in children with bilateral cataracts undergoing small incision cataract surgery and is mainly focused on children with bilateral cataracts from poorer backgrounds who tend not to receive adequate and timely medical attention. This could lead to issues such as amblyopia. However, it is important to provide surgical care even at a later date to afford some visual redemption. When affordability is the weakest link in the treatment, a manual small incision cataract surgery (MSICS) can be an ideal manner to treat bilateral cataracts. In this study, we highlight the good visual outcome post-MSICS with polymethylmethacrylate lens implantation, primary posterior capsulotomy, and anterior vitrectomy in children with bilateral cataracts who have presented at ages beyond 5 years.
Performance of chatGPT-3.5 answering questions from the Brazilian Council of Ophthalmology Board Examination
Authors: Gobira Mauro C. , Moreira Rodrigo C. , Nakayama Luis F. , Regatieri Caio V. S. , Andrade Eric , Rubens Belfort
Published: December 2023

Importance:

Large language models being approved in medical boarding examinations highlights problems and challenges for healthcare education, improving tests, and deployment of chatbots.

Objective:

The objective of this study was to evaluate the performance of ChatGPT-3.5 in answering the Brazilian Council of Ophthalmology Board Examination.

Material and Methods:

Two independent ophthalmologists inputted all questions to ChatGPT-3.5 and evaluated the responses for correctness, adjudicating in disagreements. We compared the performance of the ChatGPT across tests, ophthalmological themes, and mathematical questions. The included test was the 2022 Brazilian Council of Ophthalmology Board Examination which consists of theoretical test I, II, and theoretical–practical.

Results:

ChatGPT-3.5 answered 68 (41.46%) questions correctly, 88 (53.66%) wrongly, and 8 (4.88%) undetermined. In questions involving mathematical concepts, artificial intelligence correctly answered 23.8% of questions. In theoretical examinations I and II, correctly answered 43.18% and 40.83%, respectively. There was no statistical difference (odds ratio 1.101, 95% confidence interval 0.548–2.215, P = 0.787) comparing correct answers between tests and comparing within the test themes (P = 0.646) for correct answers.

Conclusion and Relevance:

Our study shows that ChatGPT would not succeed in the Brazilian ophthalmological board examination, a specialist-level test, and struggle with mathematical questions. Poor performance of ChatGPT can be explained by a lack of adequate clinical data in training and problems in question formulation, with caution recommended in deploying chatbots for ophthalmology.