bluuebunny/crossref_metadata_2025 huggingface dataset:
Approach to integrating molecular markers for assessment of pediatric gliomas
Authors: Mahajan Swati , Sharma M.C , Sarkar Chitra , Suri Vaishali
Published: May 2024

Recent research has promoted elucidation of the diverse biological processes that occur in pediatric central nervous system (CNS) tumors. These molecular data are leading to new guidelines for the diagnosis, offering prognostic implications and novel molecular targeted therapies. The consortium to inform molecular and practical approaches to CNS tumor taxonomy-NOW have made practical recommendations using recent advances in CNS tumor classification, particularly in molecular discernment of these neoplasms as morphology-based classification of tumors is being replaced by molecular-based classification. Here, we review the specific molecular drivers that help to define the entities that fall under the umbrella of pediatric gliomas and how to effectively test them in cost-effective manner. We discuss briefly the proposed risk-based stratification system that considers both clinical and molecular parameters to aid clinicians in making treatment decisions and the availability of an increasing array of molecular-directed therapies.
Treat the individual and not the angle
Authors: Joshi Saloni M , Nagtode Apurva H , Tejaswini Usha S , Vishwaraj C R , Venkatesh Rengaraj
Published: May 2024

Background:

Glaucoma, the silent thief of sight, is one of the most common vision-threatening conditions. Even though POAG (primary open angle glaucoma) is more common, PACG (primary angle closure glaucoma) is the dreaded variant. ISGEO (International Society for Geographical and Epidemiological Ophthalmology) has classified primary angle closure as PACS (primary angle closure suspect), PAC (primary angle closure), and PACG (primary angle closure glaucoma. The inconspicuous nature of PACS makes its diagnosis and treatment very tricky.

Purpose:

To determine which cases are best suited for laser peripheral iridotomy.

Synopsis:

Laser peripheral iridotomy is the gold standard for acute primary angle closure glaucoma treatment. But there is a lot of confusion regarding its use in PACS as a prophylactic measure. We have tried to throw light on laser peripheral iridotomy, a much debatable topic. The video focuses on various trials regarding laser peripheral iridotomy, the indications, side effects, and contraindications. We have also discussed its use as a therapeutic and prophylactic procedure.

Highlights:

The video highlights that the approach of laser peripheral iridotomy should be on a case-by-case basis.

Video link:

https://youtu.be/kiEYI9ct2Oo
Anterior vitrectomy: Simplified
Authors: Venkataraman Prasanna , Shroff Anahita
Published: May 2024

Background:

Anterior vitrectomy is a skill all cataract surgeons should develop and master. Every surgeon will have complications at some point in his/her career. Complication management should be part of the surgical training for all cataract surgeons. Posterior capsular rent does not translate to poor visual outcomes. If managed properly, excellent visual outcomes can be achieved and complications minimized. We aim to simplify the anterior vitrectomy procedure by this video.

Purpose:

This video will serve as a step-by-step practical guide to the intraoperative management of posterior capsular rent by simplifying the anterior vitrectomy procedure.

Synopsis:

This video will demonstrate how to tackle the dreaded complication of a posterior capsular rent with vitreous disturbance, and achieve optimal postoperative outcomes.

Highlights:

We demonstrate how a PCR appears, and once identified, how to proceed. In addition, nuances regarding foot positions and different vitrectomy modes are included. Biaxial vitrectomy is explained. Lens placement post-PCR is demonstrated. Furthermore, a brief about postoperative management is included.

Video link:

https://youtu.be/dTo7sMpe8h8
Can Oscillometry Replace Spirometry as a Major Tool for Lung Function Testing? – An Overview
Authors: Unnithan Jaymohan , Krishnamurthy Srikanth , Velayuthaswamy Nandagopal , Srinivasan Nagarajan
Published: May 2024

Developing countries face a huge challenge in managing obstructive lung disorders due to frequency, severity, management, and economic impact. Spirometry has been the popular choice to assess the severity and reversibility of airflow obstruction, but the success of evaluation depends on the practitioner’s skills and the patient’s cooperation. Impulse oscillometry (IOS), a variant of forced oscillation technique is preferred over spirometry since it can be performed without forced respiratory maneuvers. The objective of this review is to evaluate IOS techniques and weigh its benefits against spirometry. Publications from international electronic databases such as PubMed, Scopus, and Web of Science were searched using relevant keywords for 5 years (2018–2023). A total of 416 articles were filtered, and of these, 70 were selected which specifically discussed the principles, procedures, parameters, and interpretations of spirometry and oscillometry. From the full-text articles included, we have reflected on the history, defined, explained, compared, and contrasted spirometry and oscillometry methods to establish the versatility of oscillometry technique to identify small airway functions and its application in special clinical conditions. This review presents an easily comprehensible synthesis of oscillometry and spirometry bringing out the principles, advantages, and limitations that are suitable for a larger spectrum of healthcare and research community.
A comparative study of different animal hairs
Authors: Rajaselin A. Annika , Veeraraghavan Vishnu Priya , Arthanari A. Abirami , Gayathri R. , Kavitha S. , Selvaraj J. , Dinesh Y.
Published: May 2024

Hair is a feature that is only found in mammals. In all species, it is an epidermal protrusion composed of an outer cuticle, middle cortex, and inner medulla. Hair's primary purpose in mammals is to aid with thermoregulation. Every domestic animal species has a distinct hair pattern that can be used in forensic investigations. The aim of the present study is to observe the different animal hairs under stereomicroscope for forensic analysis. Hair is a unique characteristic seen only in mammals. It is an epidermal protrusion composed of an outer cuticle, middle cortex, and inner medulla in all species. The primary function of hair in animals is to aid with thermoregulation. Every domestic animal species has a specific hair pattern that forensic investigators can employ. The shaft profile was straight in all the animal hairs. In the proximal end, the root was absent because the hair was cut from the respective animals. Cuticles were absent in all the hair strands. The surface texture was smooth in dog hair, rough and spiculated in cat hair, and coarse in horse and rat hair. Microscopic examination of hairs reveals morphological distinctions that allow animal hairs from different species to be distinguished. In forensic investigations, microscopic examinations of various animal hairs are useful.
Anatomical and Morphological Variations in the tendons Constituting the Pes Anserinus of Knee with its Clinical Significance: A Human Cadaveric Study
Authors: Joshi Meghana Harshadbahi , Ravat Minal K , Vaniya Vasant H
Published: May 2024

Context:

Pes anserinus (PA) includes conjoined tendinous insertion of the sartorius, gracilis, and semitendinosus muscles. Each tendon can have individual insertions attached nearly in a linear arrangement. The presence of accessory tendons, bands, and structures constituting in forming PA shows high variability and has been reported clinical importance in harvesting PA graft and tendon reconstruction procedure.

Aim:

The present study aimed to macroscopically observe anatomical and morphological variations in the structures constituting in the insertion of the PA tendon and establish its clinical significance.

Subjects and Methods:

A total of ninety cadaveric lower limbs including both sexes dissected to observe variations in the structures forming PA at the anteromedial surface of the upper part of the tibia.

Statistical Analysis Used:

The descriptive statistical analysis was done.

Results:

PA was constituted of sartorius, gracilis, and semitendinosus tendons in all the specimens. The most common pattern observed was monotendinous-sartorius, gracilis, and semitendinosus in 67 (74.44%) limbs. The semimembranosus and tibial collateral ligament participation was observed in 5 (5.55%) and 2 (2.22%) limbs, respectively. The accessory band of sartorius and semitendinosus was observed in 2 (2.22%) and 14 (15.55%) limbs, respectively.

Conclusions:

PA in the medial side of the knee is a common injury site. The presence of any accessory structures or bands within can handicap graft harvesting since the gracilis and semitendinosus tendons are routinely harvested for the reconstruction procedure. Furthermore, present anatomical knowledge can be helpful to surgeons for preoperative radiological examination and to avoid complications during transplant graft surgeries of the knee.
Prevalence Rates of Tuberculosis, Human Immunodeficiency Virus, and Hepatitis B and C among Migrant Workers in Jordan
Authors: Khader Yousef , Warrad Nathirah , Maiteh Sudi
Published: May 2024

Introduction:

Migration across national borders is an influential factor of consideration in the control of infectious diseases. Therefore, including migrants in surveillance and screening programs as well as linkage to care is mandatory to meet the public health targets of countries and regions. This study aimed to determine the prevalence of tuberculosis (TB), human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) among migrant workers applying for work permits in Jordan during the period 2018–2020. The findings of this study are expected to guide health policy to prevent the spread of infectious diseases in Jordan.

Methods:

During the period 2018–2020, 439,622 migrant workers underwent routine testing for TB, HIV, and hepatitis B and C. Demographic, laboratory, and clinical data for those migrants were retrieved from the Directorate of Chest Diseases and Immigrants Health records. The overall prevalence of the mentioned diseases as well as by subgroups was calculated.

Results:

The prevalence rates of TB and HIV among migrants were 54 per 100,000 migrants (11 per 100,000 male migrants and 138 per 100,000 female migrants, P < 0.001) and 21 per 100,000 (11 per 100,000 male migrants and 41 per 100,000 female migrants, P < 0.001), respectively. The prevalence of hepatitis B was 10 per 1000 migrants (12 per 1000 male migrants and 7 per 1000 female migrants, P < 0.001) and the prevalence of hepatitis C was 37 per 1000 (51 per 1000 male migrants and 10 per 1000 female migrants, P < 0.001). The prevalence of all studied conditions varied significantly according to gender, age, occupation, and country of origin.

Conclusions:

The prevalence rates of TB, HIV, HBV, and HCV were generally higher among migrants than Jordanians. Evidence-based health policies need to be drafted that aim to address migrant workers health care to ensure the lowest possible risk from infectious diseases to the people of Jordan is maintained. The study findings can inform the formulation of immigration and public health policies, including screening requirements for migrant workers, health insurance provisions, labor regulations, and support services for those with these conditions.
Clinical Profile of Paediatric Hemangiomas, Response to Oral Propranolol, and Comparison of Intralesional Bleomycin and Triamcinolone in Propranolol Non Responders at a Tertiary Care Center in North India
Authors: Yadav Gulab Dhar , Verma Shraddha , Varshney Ashish , Deb Adiveeth
Published: May 2024

Background:

A paradigm shift has occurred regarding the treatment of cutaneous hemangiomas over the last few years, from an open surgical approach to a conservative or minimally invasive approach. There are various treatment modalities described, and response to them is variable and unpredictable. This study was conducted to study the clinical profile of children with uncomplicated cutaneous hemangiomas, their response to oral propranolol, and compare intralesional bleomycin and intralesional triamcinolone among nonresponders to propranolol.

Materials and Methods:

A trial was conducted among 158 children <12 years with cutaneous hemangiomas from January 2019 to October 2020 in Kanpur, Uttar Pradesh. Based on the response to propranolol, partial/nonresponders were later assigned randomly to either receive intralesional bleomycin (n = 30) or intralesional triamcinolone (n = 29). Response to treatment and complications were assessed in two groups. All children were followed up for 6 months.

Results:

Of 158 children, complete response to propranolol was found in 99 (62.7% [95% confidence interval (CI): 54.6%–70.1%]) children. Partial and no response was found in 33 (20.9% [95% CI: 15.0%–28.2%]) and 26 (95% CI: 16.5% [11.2%–23.4%]) children, respectively. In the bleomycin group, 66.7%, 23.3%, and 10.0% of patients showed excellent, good, and poor response, respectively, and in the triamcinolone group, 27.6%, 24.1%, and 48.3% showed excellent, good, and poor response, respectively (P = 0.002). However, there was no significant difference between them in terms of complications.

Conclusion:

Intralesional bleomycin was found to be a better drug in terms of response compared to triamcinolone. There are no significant differences in complications between them. Further studies are needed to further evaluate the combined efficacy of bleomycin with triamcinolone and other treatment modalities.
Thoracoscopic Resection of Pulmonary Lesions in Israel
Authors: Seguier-Lipszyc Emmanuelle , Rothenberg S. , Mei-Zahav Meir , Stafler Patrick , Zeitlin Yelena , Samuk Inbal , Peysakhovich Yuri , Kravarusic Dragan
Published: May 2024

Background:

Most congenital pulmonary airway malformations (CPAMs) are detected antenatally. The majority of newborns are asymptomatic. Patients are prone to subsequent respiratory complications and to a lesser extent malignant transformation remains concerning. In Israel, until 2013, pediatric surgeries were performed by thoracotomy. To minimize its morbidity, we introduced thoracoscopy using a mentorship approach. We present our experience with thoracoscopic resections coordinated by the mentorship of a pediatric worldwide leader in his field and compare our results with resections performed by thoracotomy.

Materials and Methods:

A retrospective review of records of children operated between 2013 and 2020 was conducted. Data were compared using t-test for quantitative variables.

Results:

Fifty patients were operated by thoracoscopy with a median age of 4 years, a thoracoscopic lobectomy performed in 68%. There was no conversion with a median length of stay (LOS) of 3½ days. Thirty patients were operated by thoracotomy by a thoracic surgeon with a median age of 3.5 years. A lobectomy was performed in 87% with a median LOS of 7 days.

Conclusions:

Thoracoscopic lobectomy is a technically demanding procedure with a long learning curve, strongly related to the low volume of cases. The role of a mentorship program in acquiring those surgical skills is crucial through standardization of the technique applied and supervised by the mentor. Early thoracoscopy for congenital pulmonary lesions at an early age can be achieved with a low conversion rate and minimal complications creating a change in the paradigm of practice when considering surgery for CPAM in Israel.
Role of Ultrasonography and Inflammatory Markers in Predicting Complicated Appendicitis
Authors: Banerjee Arka , Ratan Simmi K. , Neogi Sujoy , Goswami Binita , Dixit Rashmi , Panda Shasanka Shekhar
Published: May 2024

Aim:

The aim is to compare the diagnostic accuracy of laboratory investigations and ultrasonography (USG) in distinguishing complicated appendicitis (C-AA) from uncomplicated appendicitis (UC-AA).

Materials and Methods:

Forty-six children who underwent appendicectomy at our center between November 2018 and July 2020 were included. Based on intraoperative findings, they were divided into two groups – complicated (perforated, gangrenous, or associated with fecal peritonitis; n = 18) and UC-AA (n = 28). USG findings and inflammatory markers were compared in both groups at admission.

Results:

At admission, the mean values for total leukocyte count (TLC) (16090.56 vs. 11739.29 per mm3), high sensitivity C-reactive protein (hsCRP) (35.8 vs. 31.62 mg/L), and procalcitonin (PCT) (3.83 vs. 1.41 ng/mL) were significantly higher in C-AA. Visualization of a blind tubular aperistaltic structure was the only sonographic sign showing statistical significance – significantly lower in C-AA (50% vs. 90%). Independent predictors of C-AA were – duration of symptoms >48 h (odds ratio [OR] 6.3), free fluid/loculated collection in right iliac fossa (OR 3.75), TLC >11000/mm3 (OR 3.6), hsCRP >35 mg/L (OR 6.0), PCT >0.6 ng/mL (OR 4.02), and nonvisualization of appendix on USG (OR 8.33). Biochemical factors were sensitive (89%) and specific (55%) in differentiating C-AA from UC-AA but the addition of sonological parameters significantly improved the specificity of predicting complicated AA to 61% (P = 0.0036).

Conclusion:

Combining laboratory data with sonological findings significantly improves the predictive value for differentiating C-AA from UC-AA and can help decide operative approach and prognosticating.
Morbidity and mortality of necrotizing fasciitis and their prognostic factors in children
Authors: Singh Dilip Kumar , Kapoor Rohit , Yadav Partap Singh , Saxena Sonal , Agarwal Kiran , Solanki Ravi S. , Gupta Amit , Choudhury Subhasis Roy , Chadha Rajiv
Published: May 2024

Background

This is a prospective study of the clinico-etiologic profile and factors affecting outcomes in 40 children managed for necrotizing fasciitis (NF).

Materials and Methods:

Demographic details, clinical characteristics, and laboratory parameters were recorded, and the Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was calculated. Primary outcome (survival vs. nonsurvival) was noted, and prognostic factors were identified.

Results:

Initiating factors included boils (45%), i.v. cannula extravasations (22.5%), and blunt trauma (17.5%). Lesion (s) were predominantly on the lower limbs (35%) and trunk (25%). Twenty-two patients (55%) had <5% body surface area (BSA) involved. Severely deranged clinical and laboratory parameters were common. Ultrasound localized fluid collections. Pus cultures showed methicillin-resistant Staphylococcus aureus (52.5%), methicillin-sensitive S. aureus [27.5%], and polymicrobial growth (20%). Blood culture was positive in 24 patients (60%). Most isolates were sensitive to clindamycin and amoxy-clavulanate. Prognostic factors for mortality (n = 6; 15%) included categorization as “Sick,” BSA involvement >10%, thrombocytopenia, raised serum creatinine, late debridement, and polymicrobial blood culture isolates. All six nonsurvivors had a LRINEC score of ≥8 and positive blood cultures. Six patients (20.7%) developed unsightly scars and 5 (17.24%) contractures across joints.

Conclusions:

Pediatric NF has significant morbidity and mortality. Patients with adverse prognostic factors can benefit from early referral to a facility with a critical care unit. Adequate wound management is essential to minimize residual deformity.
An exploratory study on pediatric inguinal hernia videos on the youtube platform
Authors: Sehgal Mehak , Jain Divya , Goel Prabudh , Jain Vishesh , Yadav Devendra Kumar , Verma Vivek , Dhua Anjan Kumar
Published: May 2024

Aim

A study was conducted to explore the characteristics of the videos on pediatric inguinal hernia repair on YouTube and compare the most popular videos (MPV) with the least popular ones in terms of educative value vis-a-vis their popularity.

Materials and Methods:

The term “Pediatric inguinal hernia repair” was searched for on YouTube on August 15, 2021, with the filter set to “view rate.” Pertinent data were collected from the 50 MPV and the 50 least popular videos (LPV) and then compared. The h-index and affiliation of the surgeon were obtained from the Scopus database, and their affiliation was further categorized as academic or nonacademic.

Results:

One hundred and seventy-five videos were found with median views of MPV: LPV being 9270 (interquartile range [IQR] – 12099):127 (IQR – 194), respectively (P < 0.0001). Most of the videos in the MPV and LPV groups were uploaded from the United States of America (USA) (MPV – 17 and LPV – 13) and India (MPV – 15 and LPV – 15). The MPV were on YouTube for a median duration of 3.1 (IQR – 5.5) years as compared to 1.2 (IQR – 2.3) years for the LPV (P < 0.0001). Ninety-two surgeons were identified. The median h-index of the surgeons of MPV was 3 (IQR – 12) in comparison to 1 (IQR – 10) of LPV (P = 0.13). The ratio of academic versus nonacademic affiliation among MPV and LPV was almost equal in both the groups.

Conclusions:

On either end of the spectrum of popularity, the majority of the pediatric inguinal hernia videos on YouTube were surgical videos uploaded from the USA and India. The educative value of these videos was found to be low and widely dispersed. Surgeons from both academic and nonacademic affiliations had contributed similarly.
Unusual manifestations of Peutz-Jegher's syndrome in children
Authors: Vutukuru Sravanthi , Solanki Shailesh , Menon Prema , Samujh Ram , Lal Sadhna B
Published: May 2024

PeutzJegher's syndrome (PJS) is a rare, autosomal dominant disease, characterized by gastrointestinal (GI) polyps and perioral hyperpigmentation along with the increased risk of certain malignancies. In children, the most common presentation is recurrent intussusception due to polyps. These polyps can involve any part of the GI tract and can present with a variety of clinical presentations. Usually, these polyps can be removed endoscopically but often require surgical excision also. In this report, we discuss two children of PJS with uncommon presentations, one presented with retrograde intussusception and another with gastric outlet obstruction. The first child underwent laparoscopy and another required open surgery with intraoperative enteroscopy.
Our Neonatal Surgery Experiences in Somalia
Authors: Kart Yeliz , Ugur Cüneyt
Published: May 2024

Purpose:

The aim of this study is to report surgical outcomes of the neonates who have undergone various surgical procedures.

Materials and Methods:

In this retrospective study, 39 neonates who have undergone a surgical procedure in Mogadishu Somalia Turkey Recep Tayyip Erdoğan Training and Research Hospital, between October 2018 and March 2019 were included. Data regarding age, gender, diagnosis, surgical procedure, length of hospital stay, mortality, and cause of mortality were recorded.

Results:

Of 39 neonates, 12 were female (30.7%) and 27 were male (69.3%). The mean age of the neonates at admission was 7.7 ± 7.6 days (1–30 days) days. The most common diagnoses were anal atresia (n = 12, 30.8%), esophageal atresia (n = 9, 23.1%), and pyloric stenosis (n = 5, 12.8%). The most common surgical procedures were colostomy creation (n = 10, 25.6%), esophageal anastomosis (n = 9, 20.5%), primary closure of anterior abdominal wall defects including bladder exstrophy (n = 6, 15.4%), and pyloromyotomy (n = 5, 12.8%). Mortality rate was 17.9%, and mortality causes were sepsis (n = 4, 57.1%) and congenital heart disease (n = 3, 42.9%). Neonates with the highest mortality by underlying primary surgical diagnosis were esophageal atresia (n=4, 57.1%).

Conclusion:

The mortality rate from the surgical procedures of the neonates in Somalia is extremely high when compared with the developed countries. Employment of experienced pediatric surgeons and well-trained nurses, strict attention to the sanitary measures and shortening the time from birth to presentation might improve the surgical outcomes of the neonates in Somalia.
Correlation of the Position of the Anal Dimple with the Caudal Termination of the Striated Muscle Complex in Patients with Anorectal Malformations
Authors: Kumar Amit , Bangar Vipan , Khan Niyaz Ahmed , Patel Jigar N. , Gupta Amit , Yadav Partap Singh , Chadha Rajiv , Choudhury Subhasis Roy
Published: May 2024

Background:

In children with anorectal malformations (ARM), the vertical fibres of the striated muscle complex (SMC) are believed to be located within the limits of the anal dimple (AD).

Methods:

Forty five cases of ARM underwent posterior sagittal anorectoplasty (PSARP), median age 8.5 months. During PSARP the anterior, posterior limits and midpoint of the AD and SMC were marked. The location of AD was correlated with SMC.

Results:

A ‘well developed’ AD and SMC was seen in 80 % and 86.7 % patients respectively. The mean width of the AD and SMC was more in females than in males (20.96 vs. 18.98 mm and 14.24mm vs. 13.45mm respectively). In 36 cases (80 %), across the spectrum of ARM, the SMC was posterior in relation to the AD. In 7 cases (15.5 %) it correlated in position with the AD and in 2 cases (4.44 %), it was anterior to the AD.

Conclusions:

In the majority of cases AD and SMC were ‘well developed’ and the location of the SMC does not correlate with that of the AD. This has significant practical value in the important step of optimizing the placement of the rectum through the center of the SMC during repair.
Does Early Upper Tract Diversion and Delayed Undiversion in Megaureters Secondary to Severe Posterior Urethral Valves Lead to Better Renal Outcomes?
Authors: Prathap Somnath , Narayanan Sarath Kumar
Published: May 2024

Background:

There are conflicting reports for the management of severe posterior urethral valve (PUV) after ablation. The primary objective was to assess the renal outcomes using the estimated glomerular filtration rate (eGFR) and secondary outcomes in severe PUVs who underwent early partially diverting reduction ureterostomy (PDRU) and a delayed undiversion protocol.

Materials and Methods:

This 10-year retrospective study reviewed the records of 1094 boys with PUV, where severe PUV cases were treated with early PDRU (324 surgeries). We then analyzed those patients who completed the early diversion and delayed undiversion protocol. The long-term renal outcomes using eGFR and antero-posterior diameter (APD) were compared at various time points using appropriate statistical methods.

Results:

Of the 171 severe PUV patients who underwent PDRU, 31 completed undiversion and 26 (47 renal units) were analyzed after exclusions. The mean age (standard deviation) at presentation was 1.46 ± 4.1 months. Thirty-two units were refluxing and 15 were nonrefluxing megaureters. PDRU was closed at a mean age of 3.9 years and had a mean duration of follow-up of 6.4 years. The mean eGFR increased from a minimum of 10.78 ± 10.25 at baseline and remained stable at 28.69 ± 18.89 after closure of both stoma. Similarly, mean APD decreased from 12.07 ± 6.79 at the diagnosis to 7.00 ± 6.20. Three patients (3 renal units) required revision of the stoma for stenosis and 1 patient had a parastomal hernia that was repaired at the time of undiversion.

Conclusions:

In severe PUVs, early PDRU with delayed undiversion is a reliable surgical option that may ensure better renal outcomes in the long-term. Nonrefluxing renal units recover better than the refluxing. APD measurements also are shown to improve favorably.
Clinical Profile of Acute Pancreatitis in Children and Adolescents from a Single Center in Northern India
Authors: Mirza Nida , Mehta Sagar , Kumar Karunesh , Malhotra Smita , Sibal Anupam
Published: May 2024

Introduction:

There has been an increase in incidence of pancreatitis in children all over the world; studies in developed countries shown multiple etiological factors such as drugs, infections, trauma, anatomic abnormalities, and/or genetic pancreatitis in children; however, there are sparse data from the developing countries. This study was undertaken to determine the characteristics of Indian children with acute pancreatitis (AP), mainly the clinical features, etiology, complication, association, genetic factors, and outcome and recurrence.

Methods:

We performed a retrospective study of all patients under the age of 18 years, who had a final diagnosis of pancreatitis admitted at our center between 2017 and 2019.

Results:

During the 3-year period from 2017 to 2019, 40 patients were admitted at our center with AP. We found a definite etiology in 62.5% cases of patients, which were broadly grouped into seven etiologies: structural, genetic, drug induced, concurrent illness, cholelithiasis related, metabolic, and autoimmune. Recurrence of acute episodes was noted in 13 patients (32.5%). Of these, 11 were found to have a genetic mutation, underlying structural abnormality, or concurrent illness. In our study, we found that 23 patients (57.5%) had mild AP, while 14 patients (35%) had moderately severe pancreatitis; however, 3 patients (7.5%) had severe AP.

Discussion:

We found that most cases of pancreatitis in children were of mild severity, and the etiology was quite different than adults, and most cases of acute recurrent pancreatitis have a definite etiology of either genetic mutation or structural anomaly.
Dynamics of Urine Electrolytes in Term Neonates during the 1st Week of Life
Authors: Ho Sheng-Yuan , Wang Kai-Li , Fan Hueng-Chuen , Ding Jhao-Jhuang
Published: May 2024

Background:

Urine electrolyte assessment is vital for diagnosing and managing neonatal conditions. However, the challenge of urine collection in neonates has resulted in a lack of standardized urine electrolyte reference values.

Aim:

This study seeks to explore the reference levels and potential trends in serum and urine electrolytes to better understand how the kidneys handle these substances.

Methods:

Healthy neonates were prospectively enrolled following normal births. Using biochemical methods, blood and urine samples were collected and analyzed on the 1st and 5th postnatal days. Statistical analysis was performed using descriptive statistics and the Wilcoxon matched-pairs signed-rank test.

Results:

This prospective study enrolled 55 healthy neonates. Significant changes in serum electrolyte concentrations were observed between the 1st and 5th days after birth. Notably, sodium, creatinine, urea nitrogen, and uric acid levels decreased, whereas potassium, calcium, and phosphate levels increased. Urine analysis revealed significant increases in the tubular maximum phosphate reabsorption per glomerular filtration rate and decreases in the fractional excretion of potassium and uric acid by Day 5.

Conclusion:

This study challenges prevailing assumptions about the stability of neonatal urine electrolytes and highlights dynamic changes in the first postnatal week. These insights lay the groundwork for further research into electrolyte disorders in newborns and have potential implications for improving neonatal care practices.
A Comparative Study of Psychiatric Comorbidities in Patients of Head-and-Neck Cancer at Tertiary Care Hospital in North India
Authors: Meena Parth Singh , Jilowa Charan Sigh , Arora Jitendra , Prakash Prem , Jain Mahendra , Mahich Sushma , Rohilla Jitendra
Published: May 2024

Objectives:

Head-and-neck cancer (HNC) is a collective term for cancers of the oral cavity, paranasal sinuses, pharynx, larynx, skin, and salivary glands. HNC is the most common cancer in males and the third-most common cancer in females in India. It is associated with various psychiatric comorbidities; depression, anxiety, and substance abuse being the most common, so the study was planned to assess psychiatric comorbidities in hydrogen cyanide (HCN) patients in comparison to healthy controls.

Materials and Methods:

After getting approval from the institutional ethics committee, a cross-sectional study was conducted at a tertiary care center in North India. Participants recruited in the study after informed consent were of age 18 years and above, of either gender, undergoing treatment for HCN (198); their diagnosis was confirmed by histopathological examination as the study group and (140) sociodemographically matched participants as healthy controls. Participants with a history of organic brain disease, recent head trauma, or neurodegenerative disorders were excluded from the study. Sociodemographic profiles of participants were noted. For the assessment of psychiatric comorbidities, Mini-International Neuropsychiatric Interview-6 was used. The psychiatric diagnosis was confirmed by two consultants in accordance with International classifications of diseases (ICD)-10.

Results:

Most of the participants were males in their fifth decade. The most common psychiatric comorbidity in HCN patients was depression (27.3%), followed by adjustment disorder (14%). Tobacco was used by around half of patients with HNC, followed by alcohol use (16.1%).

Conclusions:

Psychiatric comorbidities were highly prevalent in HCN patients. Psychiatric disorders are known to affect both the prognosis, hospital stay, cost of treatment, and overall quality of life of cancer patients.
Epidemiological and Clinical Features of COVID-19 Confirmed Cases in Babel Governorate, Iraq
Authors: Baiee Hasan Alwan , Hussein Kahtan Hadi , Ismail Issam Salim , Abbas Mustafa Khudhair , Hammadi Ali Talib Abd
Published: May 2024

Background:

SARS-CoV-2, a newly emergent virus which is related to SARS-CoV, caused the pandemic of COVID-19 in China to the world.

Objective:

The aim of this study was to describe the basic epidemiological and clinical features of confirmed COVID-19 cases in Babel Governorate and to find out the comorbidities and risk factors of severity of COVID-19 infection.

Materials and Methods:

This is an observational, descriptive, cross-sectional study, conducted on a convenient sample of 222 participants selected from five referral district hospitals in Babel Governorate, over the period from May 12, 2020 to August 22, 2020. A structured questionnaire was used to collect data and to interview patients. Data were analyzed by using SPSS version 23.

Results:

The mean age ± SD was (49.92 ± 14.062 years) ranged between 10 and 89 years (median 50 years) with male predominance. The majority of the participants had comorbid conditions, including hypertension, diabetes mellitus, heart disease, and asthma. Fever constituted (85%) of symptoms followed mainly by persistent cough, loss of appetite, breathing difficulty, and diarrhea [(81%), (56.9%), (55%), and (42.3%)], respectively. In addition, 33.34% of the patients have SpO2 ≤ 92%, and two of the three patients have mild-to-moderate symptoms, and one-third considered either severe or critically ill cases of COVID-19.

Conclusion:

Elderly people with comorbidities are the most vulnerable to the infection of COVID-19. Smoking, obesity, traveling history, and working in healthcare facilities that contain cases of COVID-19 are risk factors leading to the occurrence of and exposure to COVID-19. People who have low level of education and are living in rural areas with big families tend to get infected mainly, and this may be due to their poor knowledge about the route of transmission and the importance of prevention measures.
A Clinicoepidemiological Study of Cerebral Palsy among Children Attending Medical Rehabilitation and Rheumatology Center
Authors: Khaleel Raed Farooq , Abdul-Aziz Rana Moayad , Katea Samah Sabar
Published: May 2024

Background:

Cerebral palsy (CP) is an umbrella term used to accurately describe a group of permanent movement and posture disorders that cause activity limitations and are caused by nonprogressive disturbances in the developing fetal or infant’s brain.

Objective:

This study aimed to evaluate the risk factors, comorbidities, and associated clinical problems with CP.

Materials and Methods:

A cross-sectional study was conducted among children with CP who attended the Medical Rehabilitation and Rheumatology Center for the first time. A random sample of 76 children aged ≤1 to 5 years who were clinically diagnosed with CP was enrolled in this study. The data were collected between January 2021 and December 2021. Sociodemographics, etiology, risk factors associated with the neonatal period, factors related to obstetric histories, and CP classification were typically gathered from a questionnaire designed for this purpose.

Results:

The majority of participants were males, 63.2%, compared with females; 47.3% of infants were born at a low birth weight <2500 g. Two-thirds of children, 64.5%, were diagnosed with CP before 1 year. Neonatal jaundice was present in 56.6% of newborns. Hypoxic-ischemic encephalopathy, 47.4%, is the most significant perinatal risk factor for CP. First-degree consanguineous marriage was observed in 35.5% of the studied sample. The mothers of 70, 92.2%, children with CP were multiparous. Most of the patients, 72.4%, had spastic CP, and quadriplegia was primarily reported in 51.3% of them.

Conclusions:

CP cannot be prevented in most cases, but the risk factors can be reduced. Early diagnosis gives the multidisciplinary team the opportunity for early intervention and rehabilitation.
Gene Expression of TNF-α among Iraqi COVID-19 Patients with a Different Severity Status
Authors: Farhan Siham Sahib , Tahmasebi Parisa , Al-Dahmoshi Hussein O. M. , Gatea Hayder Saeed
Published: May 2024

Background:

Coronavirus disease 2019 (COVID-19) individuals with varied severity group are affected by the cytokine storm brought on by SARS-CoV2 infection, which is a significant cause of acute respiratory distress syndrome.

Objective:

The goal of the current study was to examine tumor necrosis factor (TNF-α) gene expression in COVID-19 at various severity levels.

Materials and Methods:

The study includes 140 divided into 105 COVID-19-positive patients (35 for each mild, moderate, and severe group) and 35 COVID-19-negative healthy people as control. COVID-19 positive patients had 46 males and 59 females, while COVID-19-negative healthy people included 16 males and 19 females. The separation of peripheral blood mononuclear cells (PBMC) was achieved using Ficoll, and then Ribonucleic acid was extracted and converted to cDNA and the gene expression using glyceraldehyde-3-phosphate dehydrogenase as the housekeeping gene.

Results:

The results revealed non-significant differences at P < 0.05 in age among different COVID-19 groups and control (F-ratio value is 0.54257 and P-value is 0.65397). The results revealed over-expression of TNF-α gene among COVID-19 patients and the relative quantification (fold change) (mean ± standard deviation) values were 6.542 ± 7.29, 5.740 ± 6.41, 7.306 ± 8.85, and 6.580 ± 6.47 for all, mild, moderate, and severe COVID-19 patients, respectively. One-way analysis of variance test relative quantification (fold change) TNF-α (mean ± standard deviation) for mild, moderate, and severe groups revealed non-significant at P < 0.05, the F-ratio value is 0.39889 and the P-value is 0.672109.

Conclusion:

The present study concludes upregulation of TNF-α gene in PBMC of COVID-19-positive patients without significant differences among different severity groups.
The Impact of Adding Melatonin and Other Antioxidants on Post-Thaw Human Sperm Quality During Cryopreservation
Authors: Hussein Riyam , Abbas Lina Hasan , Rayhaan Suhaila , Fadhil Hawraa Abbas , AL-Mousawi Zainab R.
Published: May 2024

Sperm cryopreservation is the process of storing sperm for an extended period of time in order to maintain male fertility. Cryopreservation involves exposing germ cells to substances that prevent freezing, cooling them to below-freezing temperatures, storing, melting, and then removing the anti-freezing material when it has been used. It is helpful in cancer patients before chemotherapy and radiotherapy. Spermatozoa can be adversely impacted by reactive oxygen species by its detrimental effects on sperm membrane lipids, which cause ice crystal formation and the induction of oxidative stress (OS) during cryopreservation. Owing to the tight relationship between OS induction and cryopreservation, several recent researches have concentrated on the function of antioxidants in preserving male fertility. A variety of antioxidants have been developed for in vitro supplementation in an attempt to prevent the cellular harm brought on by cryopreservation. Examples of antioxidants include melatonin, catalase, superoxide dismutase, tocopherol, ascorbic acid, and carotenoids. When added to sperm extenders, melatonin, a natural hormone that plays a role in a number of sperm physiological processes, has frequently increased sperm viability and fertility. In order to determine whether it can protect human sperm from the damaging effects of cryopreservation, it was added to the sperm cryopreservation solution. Melatonin was added to freezing extenders in recent studies on mammals, and this increased the post-thaw activities of human sperm. Therefore, this study was aimed to review the background documents on the state-of-the-art scientific literature in this area of work. Also, this study reviewed the feasibility of employed melatonin in cryopreservation because it has antioxidant ability.
Phytochemical Screening and Antioxidant Activity of Uncaria tomentosa Extract
Authors: Oubaid Enass Najem , Abu-Raghif Ahmed Rahmah , Al-Sudani Israa Mahdi
Published: May 2024

Background:

Uncaria tomentosa is a traditional medicinal herb with antiviral, antioxidant, immunostimulating, anti-inflammatory, and anticancer effects.

Objective:

The present study was conducted to evaluate the antioxidant capacity in vitro and in vivo and the phytochemical analysis of Uncaria tomentosa.

Materials and Methods:

The plant extract was screened for phytochemical compounds and antioxidant capacity in vitro using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) method and in vivo using acetic acid-induced colitis. Colitis was induced in rats by transrectal administration (5 mL/kg) of 4% (v/v) acetic acid. Forty adult albino rats were divided into four groups: control group, acetic acid group, acetic acid + sulfasalazine (100 mg/kg/day) group, and acetic acid + Uncaria tomentosa extract (250 mg/kg/day) group. After inducing colitis, sulfasalazine and Uncaria tomentosa extract were given orally for 10 days. Data were statistically analyzed, and P < 0.05 was considered statistically significant throughout the study.

Results:

Preliminary phytochemical study showed that Uncaria tomentosa extract contains flavonoids, phenols alkaloids, saponin, and terpenoids. In the DPPH assay, the extract exhibited considerable antioxidant capacity in a dose-dependent manner. Also, Uncaria tomentosa extract dramatically decreased oxidative stress parameters, such as myeloperoxidase enzyme activity and malondialdehyde in colonic tissue. Moreover, Uncaria tomentosa treatment attenuated macroscopic colonic scores and histopathological changes induced by acetic acid.

Conclusion:

The findings of this study show that Uncaria tomentosa extract could be a source of natural antioxidants and may have a therapeutic effect on ulcerative colitis.
Molecular investigation of quinolone-resistant genes among clinical Staphylococcus aureus isolates in Babylon hospitals
Authors: Hamza Emad Noman Hassan , Fazaa Suaad Abid
Published: May 2024

Background:

Staphylococcus aureus is considered an essential etiological factor in several human infections. Although fluoroquinolones are typically used to treat these illnesses, a growing average level of resistance to these medications has been found globally in recent years.

Objective:

S. aureus is considered a main etiological agent of many human infections. Fluoroquinolones are routinely used in the drugs for these infections; however, in latest years, a growing rate of resistance to these drugs has been reported worldwide. The current study aimed to investigate the molecular resistance of quinolone (qnrA and qnrS) genes among clinical S. aureus isolates in Babylon.

Materials and Methods:

During the research, 431 clinical samples were collected from hospitals in the Babylon Health Directorate between August 2022 and January 2023. Standard laboratory procedures and biochemical tests were used to identify the bacterial isolates. Antimicrobial susceptibility was determined by the standard disk diffusion method. Polymerase chain reaction (PCR) was used for detecting the qnrA and qnrS genes.

Results:

From a total of 78 S. aureus isolates, 18 (23.77%) and 19 (24.35%) isolates of S. aureus bacteria were sensitive and intermediate to quinolone compounds, respectively, whereas 41 (52.56%) isolates showed high-level quinolone resistance. The findings revealed that the majority of them were antibiotic-resistant. Most frequently, high resistance was noted for ciprofloxacin with a ratio of 75%, followed by levofloxacin with a ratio of 72%, and high sensitivity was shown for norfloxacin with an 85% and chloramphenicol with an 80%. From a total of 41 quinolones resistance S. aureus, the qnrA gene was identified in 10 (24.39%) and qnrS in 8 (19.51%).

Conclusion:

The results showed a high rate of qnr gene resistance among the isolates of S. aureus in the Babylon hospitals, which emphasizes the need for establishing careful policies. From a total of 41 quinolones resistance S. aureus, the qnrA gene was identified in 10 (24.39%) and qnrS in 8 (19.51%).
Impact of nonsurgical and antibiotics treatment on periodontitis
Authors: Imran Azhar Abdullah , Al-Talib Zeyad Nazar M , Malik Fatima Al-Rubea
Published: May 2024

Background:

Periodontitis is one of the most prevalent chronic inflammatory noncommunicable and multifactorial diseases.

Objectives:

The present study was aimed to detect the effect of systemic antibiotics as disjunctive to nonsurgical treatment of generalized periodontitis (grade I and grade II) on the bacterial count and clinical periodontal parameters.

Materials and Methods:

Subgingival plaque samples were collected from 40 patients with generalized periodontitis, 20 patients were treated with scaling and root planning only, and 20 patients were treated with a combination of ciprofloxacin 500 mg and metronidazole 500 mg with scaling and root planning. Moreover, 20 samples were collected from healthy patients as a control group. Specific periodontal pathogen genes for Tannerella forsythia (BspA, CIpB genes) were identified using real time polymerase reaction (RT-PCR).

Results:

In this study, 120 samples were detected for the presence of T. forsythia by RT-PCR technique, and the specific ClpB, and BspA primers’ genes were used for the amplification of a fragment of these genes for the identification of T. forsythia. The results showed that the presence of ClpB and BspA in all (100%). BspA and ClpB showed a decrease but non-significant differences before and after treatment, whereas the periodontal parameter, probing pocket depth, plaque score, and bleeding on probing showed a significant decrease after treatment except clinical attachment lose showing a non-significant difference.

Conclusion:

Clinical treatment (scaling and root planning) is often helpful in the treatment of generalized periodontal disease (grade I and grade II) without the need for antimicrobial therapy as soon as possible.