bluuebunny/crossref_metadata_2025 huggingface dataset:
The current state of endovascular intervention for critical limb ischemia
Authors: Wu Hongxiao , Ye Pin , Chen Yunfei , Li Yiqing , Cai Chuanqi , Lv Ping
Published: May 2021

The treatment of critical limb ischemia (CLI) has long been a “hot spot” in medical science. It is widely believed that revascularization is the cornerstone of CLI therapy. However, there is currently no consensus on the best revascularization approach. Traditional open surgery is traumatic and associated with many complications. In recent years, great progress has been witnessed in terms of endovascular technology, gradually replacing open surgery in the treatment of CLI. In this review, the role of endovascular therapies in clinical practice, including conventional percutaneous transluminal angioplasty, bare-metal stent, and innovated drug-coated balloon, drug-eluting stent, bioresorbable vascular scaffold, cutting balloon angioplasty, atherectomy, intravascular lithotripsy, cryoplasty, and percutaneous deep venous arterialization is discussed.
Male circumcision and Sexually transmitted Infections – An update
Authors: Mehta Kajal S. , Marfatia Yogesh S. , Jain Apexa P. , Shah Dhiral J. , Baxi Disha S.
Published: May 2021

Role of male circumcision (MC) as a tool to prevent sexually transmitted infections (STIs)/human immunodeficiency virus (HIV) was assessed. An attempt was made to search articles related to association between MC and STIs/HIV. A thorough search was carried out to find out quality articles published in indexed specialty journals. Centers for Disease Control and Prevention and World Health Organization (WHO) sites were also referred. Warm and moist environment of area under foreskin facilitates some pathogens to persist and replicate. Further, the thinness of foreskin predisposes it to minor trauma and abrasions that facilitate the entry of pathogens. MC reduces HIV infection risk by 50%–60% over time and reduces the risk of men acquiring herpes simplex virus-2 and human papillomavirus (HPV) that can cause penile and other anogenital cancers, by 30%. There is no significant reduction in risk of acquiring syphilis, but reduced risk of acquisition of Haemophilus ducreyi is reported. MC is reported to be beneficial in conditions such as traumatic injury, Balanitis Xerotica Obliterans, refractory balanoposthitis, and chronic, recurrent urinary tract infections. MC also reduces the chances of penile carcinoma by facilitating improved penile hygiene, lowering HPV/HIV transmission rates, and reducing chronic inflammatory conditions such as phimosis and balanitis. MC has been recommended by the WHO and UNAIDS in 2007 as an additional HIV prevention intervention in settings of high HIV prevalence. MC is an important adjunct to safe sex education, condom use, and vaccination (HPV) in reducing the global burden of HIV/STIs-related morbidity and mortality.
Assessment of self-reported adherence to ART and patient's virological/CD4 response in a tertiary care clinic and government free ART clinic
Authors: Patel Rushin , Pandya Amee , Patel Ketan K , Malhotra Supriya , Patel Atul K
Published: May 2021

Introduction:

Treatment adherence to antiretroviral treatment (ART) is critical in reducing morbidity, mortality, and improving the survival in HIV patients. ART is a life-long commitment, and the variety of factors can influence treatment adherence. We studied the factors affecting treatment adherence in the private sector and public sector outdoor clinic in Ahmedabad, India. The primary objective of this study is to compare the level of adherence and factors that influence adherence to ART in patients attending government run free ART program and private setup.

Methods:

We conducted a cross-sectional study of 8 weeks among HIV-infected patients who were receiving ART from private clinic and free ART center from July 2019 to September 2019. We enrolled all consecutive patients >18 years of age attending both clinics. Statistical analysis was carried out using the SPSS software version 25.0. Multiple logistic regression was used to identify the factors that were independently associated with adherence to ART.

Results:

The study enrolled 306 patients, 151 (49.34%) from the outpatient department of private hospital, and 155 (50.65%) from the free ART center. Patients attending private clinics were more likely to have been diagnosed with HIV since ≥10 years compared to free ART center. Higher opportunistic infection rates were found in free ART center (64.51%). Treatment adherence was significantly lower in the patients attending free ART center (P = 0.004). Patients taking concomitant medications for other comorbid conditions (≥4 pills/day) were more likely to exhibit inadequate adherence ([odds ratio] 1.216, 95% confidence interval 1.0171–1.454). Univariate analysis showed that age, education, habits of alcohol, tobacco, number of pills, and duration of disease played a significant role in predicting adherence to ART (P < 0.05).

Conclusions:

Patients attending private clinic are surviving longer with HIV diagnosis, have fewer opportunistic infections, and have better treatment adherence compared to free ART clinic.
Virological outcome and frequency of low-level viremia in patients receiving generic dolutegravir-containing regimen at a large tertiary care clinic in Western India
Authors: Patel Atul K. , Patel Ketan K. , Pujari Sanjay , Patel Jagdish K. , Kumar Ambuj
Published: May 2021

Background:

Dolutegravir (DTG) is widely used for the management of naïve and treatment-experienced HIV-infected patients. Low-level viremia (LLV) is common in patients receiving nonnucleoside reverse transcriptase inhibitor- and protease inhibitor-containing regimens. However, the incidence of LLV associated with DTG-containing regimen is not well known.

Objective:

The objective of this study was to assess the virological response associated with DTG-containing regimens and explored frequencies of LLV and risk factors for the same.

Methods:

We performed a retrospective cohort study of HIV-infected patients receiving generic DTG-containing regimen from February 2017 to July 2019. All adult patients (≥18 years), who completed at least the first follow-up after initiating treatment, were included in this study. LLV was defined as plasma viral load between 20 and 200 copies/ml.

Results:

A total of 597 patients started DTG-containing regimen during the study period, of which 522 patients met the inclusion criteria. The study patients were categorized into five groups: naïve (n = 86), first-line failure (n = 32), second-line failure (n = 53), switch (n = 325), and HIV-2 (n = 26). Complete virological suppression at 6, 12, and 18 months was achieved in 78.5%, 81.1%, and 70.9% of the patients, respectively. Furthermore, 17.9%, 12.9%, and 23.3% of the patients had LLV at 6, 12, and 18 months, respectively. Persistent LLV was found in 2.9% of the patients. Overall, DTG was well tolerated and was discontinued in only three patients due to neuropsychiatric side effects.

Conclusion:

DTG is well tolerated and effective in suppressing HIV across all antiretroviral treatment categories. The rate of persistent LLV is low in DTG-containing therapy.
Evaluation of point of care serum cryptococcal antigen by lateral flow immunoassay for diagnosis of cryptococcosis and cryptococcal meningitis in HIV-positive patients
Authors: Kamble Ulka , Dheeresh K. H. , Bhosale Kakasaheb , Indu M. B. , Sharma Brijesh , Chowdhary Anuradha
Published: May 2021

Background:

Cryptococcal meningitis (CM) is the initial acquired immunodeficiency syndrome (AIDS) defining illness in 2% of patients with CD4 levels <100/μL and a leading cause of mortality in AIDS in the developing world. It is the most common opportunistic infection of the central nervous system in AIDS in various Indian studies. Detection of serum cryptococcal antigen (SCRAG) is the most widely used diagnostic method for cryptococcosis. The presence of cerebrospinal fluid cryptococcal antigen (CSF CRAG) is diagnostic of CM. CRAG can be determined by latex agglutination (LAT), enzyme-linked immunosorbent assay and now, by lateral flow (LFA)immunoassay. LFA is a point of care test that rapidly detects CRAG.

Aims and Objectives:

This study compares LAT and LFA for the detection of serum CRAG and diagnosing CM.

Materials and methods:

Two hundred and ten patients of HIV/AIDS were submitted to SCRAG LFA by dipstick. A sample was also sent to laboratory for SCRAG by LAT. CSF examination was done for those who were positive for SCRAG LFA and those who had symptoms suggestive of meningitis. SCRAG by LFA was compared with SCRAG by LAT, CSF CRAG by LAT and LFA, CSF cryptococcal culture and CSF India ink examination for Cryptococcus.

Results:

Fifteen patients were found positive for SCRAG by LFA dipstick. All of them were also positive for SCRAG by LAT. Twelve of them had C. D4 count below below 100 cells/mm3. CSF CRAG was positive in all 12 SCRAG positive who were submitted to CSF examination.

Conclusion:

We found that serum detection of CRAG by LFA dipstick is as sensitive as CRAG detection in serum by LAT and CSF CRAG detection by LFA and LAT. It is thus a rapid test for diagnosing CM in HIV patients with low CD4 counts.
Hyperpigmentation Post Laser Hair Removal in Patients Taking Vitamin D Supplements
Authors: Altalhab Saad , AlJasser Mohammed I. , Alshaalan Ziad M. , Ahmad Rima M. , Alghamdi Leena , Alnoshan Abdulaziz A.
Published: April 2021

Background:

Laser hair removal (LHR) is a common procedure for the removal of unwanted hair. Although it is generally safe, it is associated with some adverse effects including hyperpigmentation.

Purpose:

In this study, we aimed to assess the prevalence of postlaser hyperpigmentation in patients taking Vitamin D supplements.

Methods:

This is a cross-sectional study of patients who underwent LHR. Each patient was interviewed and asked about their intake of Vitamin D supplements, and the primary outcome was whether hyperpigmentation was reported after LHR in the past 6 months. LHR treatment details were also documented.

Results:

A total of 508 patients were included with a mean age of 29 ± 9 years. Post-LHR hyperpigmentation was more prevalent in females and in those taking oral Vitamin D. Multivariate logistic regression analysis showed that Vitamin D intake was independently associated with more risk of hyperpigmentation post LHR (odds ratio [95% confidence interval]; 2.6 [1.17–5.80], P = 0.020).

Conclusion:

Vitamin D intake may be associated with an increased risk of hyperpigmentation post LHR. Causality cannot be assessed.
Management of Localized Juvenile Spongiotic Gingival Hyperplasia
Authors: Mawardi Hani H. , Almazrooa Soulafa A. , Turkstani Heba A. , Balkhair Razan S. , Almasoudi Alaa G. , Bakhamis Bushra A. , Azzouz Lujain Z. , Alshareef Tahani A. , Alsulami Soha E. , Alsahafi Sarah A. , Albarqi Asma A.
Published: April 2021

Background:

Localized juvenile spongiotic gingival hyperplasia (LJSGH) is an uncommon condition presenting as a well-circumscribed, papillary, and exophytic red soft-tissue lesion commonly on the gingival margin and attached gingiva with distinctive histological features. Up to date, the exact etiology is yet to be determined, while a reactive nature of the disease was suggested.

Purpose:

The aim of this systematic review is to investigate various LJSGH treatment options for the best outcome.

Methods:

A search was conducted using PubMed/Medline and Medscape up to April 2019. All English literature on management of LJSGH was included and systematically reviewed for bias and using different levels of elimination by multiple reviewers. The required data from eligible studies were extracted and analyzed.

Results:

Twelve articles met the inclusion criteria following the Preferred Reporting Items for Systematic Reviews and Meta-analysis statement. In total, 97 cases were treated by surgical excision in which 12 had recurrence within a median follow-up of 29 months. Two cases were treated with cryotherapy, one with photodynamic therapy, and one case with surface cauterization with topical clobetasol all with no reported recurrence. In addition, one case was treated with scaling and chlorhexidine application without significant response.

Conclusion:

Based on the available evidence, the complete excision of LJSGH using any method may have the most predictable outcome. Further studies are needed to confirm these findings and explore alternative management options.
Challenges, experiences, and postoperative outcomes in setting up first successful lung transplant unit in India
Authors: Rahulan Vijil , Shah Unmil , Yadav Pavan , Ravipathy Srinivasa , Jindal Apar , Suresh S , Sandeepa HS , Kumar Pradeep , Mohandas Anoop , Kumar Sharanya , Shivanna Shivaprakash , Kori Santosh , Dutta Prabhat , Anand Prem , Mahesh BN , N Madhusudana , Bhaskar BV , Balasubramani G , Attawar Sandeep
Published: April 2021

Background:

Lung transplantation (LT) has emerged as a definitive cure for a plethora of end-stage lung diseases (ESLDs). With improvements in immune-suppression protocols, the posttransplantation survival rates have gone up.

Aim:

The study reported the initial experience of the India's single largest lung transplant program on clinicopathological profile, procedures, challenges encountered, and outcomes.

Settings and Design:

A retrospective analysis was done from data available at three centers of Institute of Heart and Lung Transplant, Gleneagles Global Hospitals across Chennai, Bengaluru, and Mumbai.

Materials and Methods:

A total of 132 patients underwent lung (single or bilateral) or combined heart and lung transplant between April 2017 and March 2020. All the participants had 30 days' follow-up. Postoperative complications, graft rejection, and 30-day mortality were reported. Kaplan–Meier survival analysis and logistic regression analysis were performed.

Statistical Analysis Used:

Kaplan–Meier survival and binary logistic regression was performed.

Results:

Interstitial lung diseases, 65.91%, were the most common diagnosis. Bilateral LT (81.3%) was the most common type of LT performed. Grade III primary graft dysfunction was observed in 16 (12.1%). Distal airway stenosis (21.97%) was the most common complication followed by anastomotic stenosis (14.30%). Gram-negative bacterial sepsis (52%) was the leading cause of death. Cumulative probability of survival at 1 month was 0.85 (95% confidence interval [CI] 0.80–0.92), and at 1 year, it was 0.78 (95% CI, 0.72–0.86).

Conclusion:

This study establishes the fact that despite multiple challenges, LT is a viable option for selected patients with ESLDs in India and should encourage early referrals to a transplant center.
Isoprostane-8 in the exhaled breath condensate
Authors: Bodini Alessandro , Pecoraro Luca , Tenero Laura , Pezzella Vincenza , Pradal Ugo , Piacentini Giorgio
Published: April 2021

Background and Objectives:

Exhaled breath condensate (EBC) represents a potential diagnostic tool for Primary Ciliary Diskinesia (PCD). An increased oxidative stress is present in the airways of children affected and many neutrophil chemoattractants and markers of oxidative stress can be involved. The aim of the study is to evaluate leukotriene B4 (LTB-4), interleukin 8 (IL-8), 8-isoprostane (8-IP) concentration in PCD subjects, investigating their potential role as non-invasive markers of inflammation for the diagnosis and management of PCD.

Methods:

Cross-sectional study. 43 patients were enrolled in the study and divided in two groups: PCD (27) and healthy subjects (16). Physical examination, lung function test, nFeNO measurement and EBC collection were performed in all subjects.

Results:

PCD subjects showed an EBC 8-IP concentration significantly higher than the control group (median value: 11.9 pg/ml; IQR, 5.5–24.0 vs. median, 6.7 pg/ml; IQR, 2.5–11.3, p-value of Wilcoxon rank-sum test 0.0436). LTB4 EBC concentration did not differ between the two group (median, 4.3 pg/ml; IQR, 3.0–8.8 vs. 7.5 pg/ml; IQR, 3.0–9.5; P=0.4901). No significant correlation was found between FEV1 and EBC 8-IP (r=-0.10, P=0.6314) or LTB4 concentration (r=0.03, P=0.8888) in PCD subjects. No significant correlation was found between nFeNO and EBC 8-IP (r=-0.31, P=0.1385) or LTB4 (r=0.04, P=0.8565) in PCD subjects.

Conclusions:

EBC 8-IP levels are significantly increased in PCD subjects, highlighting the role of oxidative stress in airway inflammation. It could have a potential role as a non-invasive marker of inflammation for the diagnosis and management of PCD, although a therapeutic application of this evidence seems far.
Central airway abnormalities – More than meets the eye
Authors: Singh Swish Kumar , Jana Manisha , Bhalla Ashu Seith , Naranje Priyanka , Ray Animesh , Soneja Manish , Khan Adil Rashid
Published: April 2021

Central airway abnormalities are the most overlooked part of the respiratory system during high-resolution computed tomography thorax specifically when these are subtle and read by less experienced eyes. In this article, we have tried to emphasize the importance to include central airways in reporting checklist. Systematically, analysis of airways can give important clues and narrow down the differentials and clinch the diagnosis in some cases like in our index one.
Ocular Disorders among Preschool Children in Southwest Nigeria
Authors: Adejumo Olubusayo O. , Olusanya Bolutife A. , Ajayi Benedictus G.
Published: April 2021

PURPOSE:

The aim of the study was to determine the prevalence and causes of ocular disorders among preschool children.

METHODS:

A multi-stage random sampling technique was used to select 560 children from a total of 9944 children aged 3–5 years attending nursery schools in the study area. Demographic and other relevant data were collected from the children. They underwent full ophthalmic evaluation including anterior and posterior segment examination as well as cycloplegic autorefraction.

RESULTS:

Out of the 560 children screened, 170 (30.3%) were 3 years old, 183 (32.7%) were 4 years old, while the remaining 207 (37.0%) were 5 years old. Male-to-female ratio was 1:1.1. Visual acuity was testable using Lea symbol chart in 90% of the children. Ocular disorders were found in 61 eyes of 35 children giving a prevalence of 6.3%. The most common ocular disorder among participants was refractive error (3.9%), followed by allergic conjunctivitis (1.3%). Other identified ocular disorders were strabismus (0.9%), congenital cataract (0.4%), congenital ptosis (0.4%), optic atrophy (0.4%), ectopia lentis (0.2%), and phthisis bulbi (0.2%). There was no statistically significant difference in the distribution of ocular disorders by age or gender.

CONCLUSION:

Screening is useful in early detection and treatment of ocular disorders in preschool children. Uncorrected refractive error which was identified as the major ocular disorder in these children is treatable. Periodic preschool vision screening would reduce the burden of uncorrected refractive error and other ocular disorders which can interfere with the learning skills of young children entering school.
Outcomes of Combination Therapy using Aflibercept and Dexamethasone Intravitreal Implant versus Dexamethasone Monotherapy for Macular Edema Secondary to Retinal Vein Occlusion
Authors: Harb Walid , Chidiac Georgio , Harb Georges
Published: April 2021

PURPOSE:

The purpose of this study was to evaluate the efficacy of the combination therapy of intravitreal aflibercept 2 mg (Eylea®) and a sustained-release dexamethasone 0.7 mg intravitreal implant (Ozurdex®) versus dexamethasone alone in providing better visual acuity in eyes with macular edema (ME) secondary to retinal vein occlusion (RVO).

METHODS:

Seventy-four eyes of 74 patients with treatment-naïve ME secondary to RVO were included in this prospective nonrandomized case series and were studied over a 12-month follow-up period. Patients in the dexamethasone monotherapy group were treated with an initial Ozurdex® injection while patients in the combination therapy group were treated with an Eylea® injection followed 2 weeks later by an Ozurdex® injection. The treatment was repeated as needed. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and intraocular pressure were evaluated periodically. The primary outcome measure was the BCVA. The secondary outcome measures included CMT, number of retreatments, and safety parameters.

RESULTS:

At 1 year, the primary endpoint was met. Patients receiving combined therapy had better mean visual acuity changes from baseline compared to those receiving monotherapy (0.369 ± 0.221 logarithm of the minimum angle of resolution [logMAR] vs. 0.218 ± 0.171 logMAR; P = 0.002). The secondary endpoints were not met since there were no significant differences in mean reductions in CMT (272.67 ± 82.35 vs. 248.11 ± 159.73; P = 0.412) and the mean number of retreatments was similar in the two groups (1.75 ± 1.13 vs. 1.42 ± 0.64; P = 0.126).

CONCLUSION:

Aflibercept with dexamethasone implants achieved better visual outcomes compared to dexamethasone monotherapy with no significant differences in intravitreal retreatment rates at the 1st year in eyes with ME secondary to RVO.
Prescription Pattern and Blood Pressure Control among Patients on Antihypertensive Medications Attending a Tertiary Hospital in Lagos
Authors: Ogundele Sunday Oladunjoye , Ajibare Adeola Olubunmi , Amisu Mumuni A. , Dada Akinola Olusola
Published: May 2021

Context:

Hypertension is a disease of global public health importance affecting an estimated 1 billion people worldwide. Hypertension accounts for about 10.4 million deaths in 2017. Many guidelines are available for the management of hypertension, but despite this, there are wide variations in physicians' choice of antihypertensive medications for blood pressure (BP) control.

Aims:

We reviewed the prescription pattern of antihypertensive medication and the level of BP control in patients with hypertension.

Settings and Design:

This is a cross-sectional study among hypertensive patients attending follow-up clinics of a tertiary hospital.

Methodology:

Structured questionnaires were used to collect information on the antihypertensive medications and clinical profiles of the study participants. Questionnaires were administered to participants during the attendance of the follow-up clinic to capture information relevant to the study. Information retrieved from patients includes details about their baseline demographic characteristics, clinical history, antihypertensive drug history and blood BP recordings. The study protocol was reviewed and approved by the institutional ethics committee.

Statistical Analysis:

Data were analysed using Microsoft Excel 2003 and the Statistical Package for the Social Sciences version 22.0 software.

Results:

A total of 489 hypertensive patients took part in the study. The study found that the rate of BP control was 44.6% among the participants. Calcium channel blockers (CCBs) are the most common antihypertensive medication prescribed in our clinics. There was no significant relationship between how long a patient had been attending the follow-up clinic and the level of BP control in patients who have attended the clinic for a minimum period of 3 months.

Conclusion:

BP control was less than optimal in more than half of the participants, and the most commonly prescribed antihypertensive medication were CCBs.
Chronic Pyogenic Osteomyelitis of the Rib
Authors: Adamu Kabir Musa , Inuwa Ismail Muhammad
Published: May 2021

Rib osteomyelitis is extremely rare and accounts for <1% of haematogenous osteomyelitis. We report a rare case of chronic pyogenic osteomyelitis involving the rib in a 29-year-old female sickle cell disease (SCD) patient who presented with recurrent discharging sinus over the right chest wall for 20 years. The patient had partial excision of the 5th rib/sequestrectomy with chest tube insertion. She did very well and was discharged after chest tube removal to the orthopaedic outpatient department for follow-up. Being of various aetiology with non-specific clinical manifestation, its diagnosis is challenging. Clinicians should be aware of the possibility of rib osteomyelities in a SCD patient. Early recognition and prompt treatment allow high cure rate.
Prevalence of Electromechanical Dyssynchrony among Heart Failure Patients in a Nigerian Tertiary Hospital
Authors: Ahmad Bashir Garba , Mijinyawa Muhammad Sani , Sani Mahmoud Umar
Published: May 2021

Context:

Heart failure (HF) is among the most important causes of morbidity and mortality worldwide. Cardiac dyssynchrony, a situation associated with a difference in the timing of contractions in different chambers and/or segments of the heart, is frequently seen in patients with HF and is a poor prognostic marker if left untreated. There is limited information on the prevalence of dyssynchrony among HF patientsin our environment.

Aims:

We set out to assess the prevalence of electromechanical dyssynchrony using electrocardiography and echocardiography among HF patients in a Nigerian tertiary hospital.

Settings and Design:

We conducted a prospective observational study among adult HF patients in our hospital.

Methods and Materials:

One hundred patients were consecutively recruited and detailed history and examination were done. Electrical and mechanical dyssynchrony were measured using electrocardiography and echocardiography, respectively.

Statistical Analysis:

Data were analysed using Microsoft Excel 2003 and the Statistical Package for the Social Sciences version 16 software.

Results:

A total of 100 participants were recruited, 67% were females. The mean age of the study population was 41.95 ± 16.07 years. Electrical dyssynchrony (QRS ≥120 ms) was found in 11%, interventricular and intraventricular dyssynchrony were seen in 79% and 75%, respectively. There was a significant association between prolonged QRS and intraventricular dyssynchrony, and between inter and intraventricular dyssynchrony.

Conclusion:

Electromechanical dyssynchrony is prevalent among HF patients in our environment. Larger multicentre studies are needed in our country to fully define the burden of dyssynchrony and study the characteristics of patients with it in order to properly manage them.
Bilateral Pelvic Kidneys in a Haemophiliac
Authors: Abdulmalik Mohammed Aliyu , Hafiz Atiku , Mustapha Mohammed Alhaji
Published: May 2021

Renal migration anomalies are rare and often under-reported. Kidneys that fail to ascend to their normal location in the renal fossa are usually termed 'ectopic' kidneys, which can be unilateral or bilateral. Those that fail to ascend above the pelvic brim are commonly termed pelvic kidneys. We present a case of a 41-year-old male haemophiliac on routine investigation with a previous history of anaemia and bone pains, currently asymptomatic. He was found to have malrotated pelvic kidneys with vascular anomalies. Even though most patients with pelvic kidneys are asymptomatic, they are usually discovered in childhood or as young adults. This case is important because, in addition to the late discovery of the bilateral pelvic kidneys, there is coexistence of a bleeding disorder which may pose a challenge in patients' management. This is to also make the patient aware of his condition and avoid taken unnecessary risk which might make his condition worse.
"Thrombectomy and Back
Authors: Al-Jehani Hosam , AlHamid May Adel , Hudhiah Kawthar , Al-Bakr Aisha , Bunayan Reem , AlAbbas Faisal
Published: May 2021

Background:

Timely access to comprehensive stroke centers for patients suffering from acute ischemic stroke due to large vessel occlusion (LVO) remains a commonly encountered obstacle worldwide, especially in areas with no comprehensive stroke or thrombectomy-capable stroke centers.

Objective:

To present our novel experience with a “thrombectomy-and-back” model implemented in the Eastern Province of Saudi Arabia.

Methods:

King Fahd Hospital of the University (KFHU), a 600-bed hospital located in Al Khobar with an open-access emergency department, was designated as a comprehensive stroke center in the Eastern Province. “Thrombectomy-and-back” was designed such that the neurologist in the referring hospital directly communicates with the attending neurovascular team at KFHU for their anticipation of the case, and subsequently confirms LVO presence through urgent acquisition of a CT and a CT angiogram. Once LVO was confirmed, the patients were timely transferred to KFHU for mechanical thrombectomy. Upon procedure completion, the patients returned to the referring hospital with the same medical and EMS team. The safety of transfer and peri-procedural complications were analyzed.

Results:

From December 2017 to December 2019, 20 thrombectomy-and-back codes were activated, of which 10 were deactivated on negative LVO and 10 remained activated. Of these 10 patients, 2 required admission to our hospital's Neuro-ICU: one was because the middle cerebral artery reoccluded during the procedure and the other was due to hemodynamic instability upon arrival; this first patient passed away 2 months later due to the complications of the malignant left middle cerebral artery stroke.

Conclusions:

The novel Thrombectomy-and-Back model in the Eastern Province of Saudi Arabia has proved to be a safe and efficient approach for patients presenting with LVO to receive timely interventional therapy and minimizing futile transfers.
Gemcitabine Plus Platinum versus Docetaxel Plus Platinum as First-Line Therapy for Metastatic Nasopharyngeal Carcinoma
Authors: Yang Hui , Lu Ying , Xu Zhuohua , Wei Mingjing , Huang Haixin
Published: May 2021

Background:

A well-established first-line chemotherapy standard for metastatic nasopharyngeal carcinoma is yet lacking.

Objectives:

To compare the efficacy and safety of gemcitabine plus platinum versus docetaxel plus platinum regimen as first-line therapies for distal metastatic nasopharyngeal carcinoma.

Study Design and Participants:

A single center, randomized, open-label, parallel-arm study. The study included 120 patients with metastatic nasopharyngeal carcinoma who met the study requirements.

Interventions:

Participants were randomized in a 1:1 ratio through a sealed envelope selection. Gemcitabine 1000 mg/m2/d intravenously (IV) for >30 min (days 1 and 8) or docetaxel 75 mg/m2/d IV for 1 h (day 1) were administered to the respective group participants. Nedaplatin 75 mg/m2/d, IV (day 1), cisplatin 75 mg/m2/d IV (day 1) or carboplatin (area under the curve set as 5) IV (day 1) were used in both groups. One cycle duration was 21 days, with 4–6 cycles for all participants.

Outcomes:

The primary assessed outcomes were progression-free survival (PFS) and overall survival (OS), and the secondary outcomes were short-term efficacy [i.e., response rate (RR) and disease control rate (DCR)] and safety.

Results:

Seven patients withdrew from the study, and efficacy and adverse reactions were obtained for 113 patients (gemcitabine: 56; docetaxel: 57). Compared with the docetaxel plus platinum group, the gemcitabine plus platinum group had significantly higher RR (71.4% vs. 52.6%, P < 0.05); mPFS (9.7 vs. 7.8 months, P < 0.05), and mOS (20.6 vs. 16.8 months, P < 0.01). The significance was not associated with increased adverse reactions, as both groups showed similar Grades 3 and 4 adverse reactions (P > 0.05). DCR was non-significantly higher in the gemcitabine group (85.7% vs. 75.4%, P > 0.05). Multivariable analysis revealed that time to disease progression, number of involved organs, liver metastasis, and grouping were associated with mPFS and mOS (all P < 0.05).

Conclusion:

The combination of gemcitabine with platinum is likely superior to that of docetaxel with platinum as first-line treatment for metastatic nasopharyngeal carcinoma.
Cyclicity of elliptic curves modulo primes in arithmetic progressions
Authors: Akbal Yıldırım , Güloğlu Ahmet M.
Published: May 2021

We consider the reduction of an elliptic curve defined over the rational numbers modulo primes in a given arithmetic progression and investigate how often the subgroup of rational points of this reduced curve is cyclic.
Immunoblot for the Diagnosis of Cutaneous Leishmaniasis in French Guiana
Authors: Menu Estelle , Blaizot Romain , Mary Charles , Simon Stéphane , Adenis Antoine , Blanchet Denis , L’Ollivier Coralie , Ranque Stéphane , Demar Magalie
Published: May 2021

Cutaneous leishmaniasis (CL) is firmly established in South America. We aimed to assess the detection of IgG antibodies against 14 and/or 16 kDa antigens by immunoblot (IB) for CL serological diagnosis in French Guiana, an area where many endemic pathogens could interfere with it. This study was performed retrospectively on sera from 141 patients at the Cayenne tertiary hospital: 30 were patients with confirmed CL, 71 were diagnosed with various other endemic pathogens, 11 were diagnosed with an autoimmune disease, and 29 controls had no history of CL. Antibodies bound to the 14 and/or 16 kDa antigens in 27 of the 30 CL patients’ sera and in 39 of the 111 non-CL patients’ sera (26 from the infectious diseases group, four from the autoimmune diseases group, and nine from the dermatology department). The method tested showed a high sensitivity (90%) and a low specificity (66%), and a diagnosis odds ratio of 17.5 (95% CI [4.6–78.0]). This IB may be helpful to exclude the diagnosis of CL, prompting physicians to look for another diagnosis in the case of a negative IB.
Epidemiology, Ecology and Prevention of Plague in the West Nile Region of Uganda: The Value of Long-Term Field Studies
Authors: Eisen Rebecca J. , Atiku Linda A. , Enscore Russell E. , Mpanga Joseph T. , Acayo Sarah , Mead Paul S. , Apangu Titus , Yockey Brook M. , Borchert Jeff N. , Beard Charles B. , Gage Kenneth L.
Published: May 2021

Plague, a fleaborne rodent-associated zoonosis, is a neglected disease with most recent cases reported from east and central Africa and Madagascar. Because of its low incidence and sporadic occurrence, most of our knowledge of plague ecology, prevention, and control derives from investigations conducted in response to human cases. Long-term studies (which are uncommon) are required to generate data to support plague surveillance, prevention, and control recommendations. Here we describe a 15-year, multidisciplinary commitment to plague in the West Nile region of Uganda that led to significant advances in our understanding of where and when persons are at risk for plague infection and how to reduce morbidity and mortality. These findings provide data-driven support for several existing recommendations on plague surveillance and prevention and may be generalizable to other plague foci.
Management and Complications of Nasal Septal Collections
Authors: Sogebi Olusola Ayodele , Oyewole Emmanuel Abayomi
Published: May 2021

Background: Nasal septum collections (hematoma and abscess) can lead to structural and functional abnormalities. Our objective was to assess the clinical characteristics, management and complications of nasal septal collections, and document factors associated withtheir complications. Methods: This was a retrospective study of patients managed for nasal septal collections. Socio-demographic and clinical information was recorded, and the main investigations and results noted. Follow-up and complications of septal collections were documented and the clinical factors associated with the complications explored. Results: Twenty-four patients records were studied: male: female ratio=2:1, mean age 40.1±13.1years,62.5% presented with complaints of nasal obstruction, 66.7% had antecedent nasal trauma, presentation was from 2 to 13 days,25%had co-morbid disease(s). All patients had incision and drainage of the septal collection within 1–7 h; 41.2% of the aspirated collections cultured microorganisms, 20.8% developed complications. Increased age above 45 years, co-morbidity, delayed presentation, culture-positive aspirate was all significantly associated with development of complications. Conclusion: Nasal septal collections were more common in adult males with antecedent nasal trauma; 20% developedcomplications associated with the presence of culturepositive abscesses, increased age, and duration of septal collection.

Keywords: Nasal trauma, Septal hematoma, Septal abscess, Complications
Petrography and Geochemistry of some Granitoids associated with Gold Mineralisation at Mpohor area in southeastern Ashanti Belt of the Birimian, Ghana
Authors: Tetteh G. M. , Effisah-Otoo E.
Published: April 2021

Mpohor area in Western Region of Ghana is located within the Birimian at the southeastern corridor of Ashanti belt. Diamond drilling in the area which encloses Father Brown concession intersected steeply dipping igneous rocks on which petrographic and whole rock XRF analyses were conducted to describe the rock types according to mineralogy, texture, alteration and mode of mineralisation. The study showed that gabbro and diorite are weakly deformed, partially altered and of greenschist facies metamorphism. These rocks intruded into belt granitoids which accompanied metavolcanic rocks (well exposed at a coastal region to the southeast). Subsequent tonalite and granodiorite intrusives into sheared areas of gabbro are deformed with foliation being parallel to the major foliation in the host rock. This ductile deformation was accompanied by brittle deformation and infiltrated by hydrothermal fluids leading to silicification, carbonatisation, sericitisation, pyritisation of second and third generations and gold mineralisation. On the contrary, chloritisation with fine chalcopyrite together with pyrite of first generation characterise host gabbro and diorite. Hence deformed pyrite porphyroblast of second generation is found in tonalite and partly in contact with magnetite and also associated with gold. The ore zone (Au grade between 1.78 to 48.80 g/t) in tonalite is characterised with lower TiO2 content (<0.73 wt %) in addition to Fe/Mg ratio above 2.4 and Zr values less than 100 ppm which may suggest that mineralised fluid was depleted of Ti and Zr and Mg/Fe ratio above 2.4. These probably show that hydrothermal fluid which has the potential for high sulphide-Au mineralisation accompanied more mafic host rocks. Keywords: Petrography, Geochemistry, Granitoids, Gold Mineralisation, Southeastern Ashanti belt
Preg-robbing of Gold by Carbonaceous Materials Encountered in Gold Processing
Authors: Amanya F. , Ofori-Sarpong G. , Anni V. , Amankwah R. K.
Published: April 2021

Processing of gold from refractory ores containing carbonaceous materials (CM) poses challenges due to the ability of the CM to preg-rob dissolved gold. Depending on the type and maturity of CM encountered, preg-robbing of aurocyanide ion can lead to reduction in gold recovery ranging from a few percentages to more than 50%. Knowledge on the type of CM present, and its capacity for gold adsorption is important in predicting pre-treatment methods that can deactivate the CM and reduce its ability to preg-rob. This paper, as part of an on-going work, presents results on the degree of adsorption by the various carbonaceous materials encountered in gold processing, and estimates the amount of aurocyanide complex preg-robbed by them. To do this, various weights of carbonaceous materials (wood chips, charcoal, barren carbon and fresh activated carbon) were contacted with gold solution for a given period of time. The percentages of gold adsorbed on the various carbons were determined, and the results showed an increasing trend of preg-robbing in favour of wood chips < charcoal < barren carbon < activated carbon. Of all the CMs, wood chips have not undergone any carbonisation and/or activation, and thus exhibited the lowest affinity. The adsorption capacities in grams of gold per tonne of carbon over a 24-hr period were 30-65 for wood chips, 320-370 for charcoal, 410-420 for barren carbon and 580-650 for activated carbon. The trend shows direct correlation with the activities and the degrees of graphitisation and maturity of the various carbonaceous materials. It is thus important to characterise carbonaceous gold ores to know the maturity of the CM present, which will inform on the pre-treatment processes required. Keywords: Preg-Robbing, Wood Chips, Charcoal, Activated Carbon
Teneurs en phénols totaux, activités antioxydantes des macérés et décocté des feuilles de Uvaria chamae P. Beauv. (Annonaceae)
Authors: Bamba Bourahima , Benie Comoé Koffi Donatien , Ouattara Abou , Doukourou Dahiro Noël , Kamou Richard Kamou , Ouattara Karamoko
Published: May 2021

Uvaria chamae est une plante de la biodiversité Ivoirienne utilisée en médecine traditionnelle. Malgré les vertus biologiques et thérapeutiques de cette plante, peu d’informations sur la teneur en phénols totaux et l’activité antioxydante existent. L’objectif de cette étude était d’évaluer la teneur en phénols totaux, l’activité antioxydante de macéré aqueux, de macéré éthanolique et de décocté aqueux des feuilles de Uvaria chamae. La teneur en phénols totaux a été effectuée par la méthode de Folin-Ciocalteu. L’activité antioxydante a été évaluée par la méthode de piégeage du DPPH (2,2-diphenyl-1-picrylhydrazyle) et d’ORAC (Oxygen Radical Absorbance Capacity). La teneur en phénols totaux était respectivement de 110,51 ± 7,18 µg GAE/mg d’extraits, de 86,34 ± 1,38 µg GAE/mg d’extrait et de 65,80 ± 0,13 µg GAE/mg d’extrait pour le macéré éthanolique, le décocté aqueux et le macéré aqueux de Uvaria chamae. Les différents macérés et décocté ont présenté une activité de piégeage des deux radicaux libres. S’agissant du radical DPPH, le macéré éthanolique de U. chamae exerce une forte activité antiradicalaire significative avec un CI50 de l’ordre de 0,08 ± 0,02 mg/ml. Avec la méthode ORAC, le macéré éthanolique de U. chamae (3,51 ± 0,15 µmol TE/µg d’extrait) et le décocté aqueux de U. chamae (3,36± 0,18 µmol TE/µg d’extrait) présentent des valeurs d’activités antioxydantes significatives. Par contre, les valeurs de l’activité  antioxydante du macéré aqueux de U. chamae (3,04 ± 0,20 µmol TE/µg d’extrait) et du témoin positif : extrait éthanolique de R.  officinalis (2,54 ± 0,06 µmol TE/µg d’extrait) ne sont pas significativement différentes (P ˃ 0,05). Ces résultats montrent l’existence d’une bonne corrélation linéaire entre la teneur en phénols totaux et le pouvoir antioxydant des différents macérés et décocté de cette plante. Cette plante Ivoirienne pourrait donc être considérée comme une source d’antioxydant naturel à des fins médicinales.Mots clés : Uvaria chamae, teneur en phénols totaux, antioxydant, Côte d’Ivoire
Diversité floristique, structure et distribution des groupements végétaux des parcours d’accueil des transhumants dans la Basse et Moyenne Vallée de l’Ouémé au Bénin
Authors: Honvou Sylvanus Hanania Sèton , Aboh Boya André , Sewade Clément , Teka Oscar , Gandonou Bernard Christophe , Oumorou Madjidou , Sinsin Brice
Published: May 2021

La perte de la biodiversité végétale, liée à la dégradation des parcours est l’un des défis pour les pays d’accueil des transhumants. La présente étude visait à analyser les caractéristiques structurales et la diversité floristique des groupements végétaux dans la Basse et Moyenne Vallée de l’Ouémé (BMVO). Les données phytosociologiques, collectées dans 113 relevés selon la méthode de Braun-Blanquet (1932), ont été soumises à une DCA avec le logiciel R 3.3.2. Ainsi, 173 espèces regroupées dans 127 genres et 45 familles ont été  recensées. Au total, 4 groupements végétaux ont été identifiés : les groupements GI à Andropogon gayanus var squamulatus et Mitragyna inermis ; GII à Paspalum notatum et Aeollanthus pubescens ; GIII à Panicum maximum et Calopogonium mucunoides et le groupement végétal GIV à Tridax procumbens et Daniellia oliveri. La diversité floristique est liée à la topographie, la nature du sol et son humidité, et l’intensité d’exploitation des terres. Les thérophytes et les phanérophytes ont été les plus abondants dans tous les groupements. Par contre, les hémicryptophytes ont été plus dominants dans le groupement GI. Les espèces à large distribution et à distribution continentale ont été plus abondantes et dominantes dans tous les groupements. Cette recherche servira de base pour l’analyse de la dynamique de la végétation des terres de parcours de la BMVO.

Mots clés : Parcours, facteurs écologiques, types biologiques, types phytogéographiques, Bénin.
Comparative Egg Production, Quality and Hatchability in Three Chicken Genotypes under Humid Tropical Conditions
Authors: Omoyara O.P , Abioja M.O , Iyasere O.S , Egbeyale L.T
Published: May 2021

Comparative study on egg production and hatchability characteristics in Nigerian local (NL; n=24), FUNAAB-α (F-α; n=24) and Transylvanian naked neck (TNN; n=24) chickens aged 25 weeks old was carried out for 4 weeks. Three hundred and sixty hatchable eggs each were used for quality characteristics determination and for incubation. F-α had significantly (P<0.001) higher egg production (90.3%) than TNN (76.9%) while TNN was higher than NL (58.3%). Egg weight (EWT), length, width and surface area, albumen height, weight, percentage and index, shell weight, color and internal quality unit (IQU) were significantly (P<0.001) affected by genotype. These followed the pattern: NL<F-α<TNN. F-α and TNN had significantly (P<0.001) higher values than NL in egg shape index, yolk weight, height and diameter. Yolk colour index was significantly (P<0.01) higher in TNN than in F-α. Yolk percentage and yolk-albumen ratio followed the pattern: NL>F-α>TNN. NL had (P<0.001) thicker and higher shell percentage (SP) than F-α and TNN. Higher Haugh unit (HU) was recorded in TNN than in NL and F-α. Fertility was significantly (P<0.05) higher in F-α than in TNN. Hatchability was not (P>0.05) affected by genotype. Chick weight and chick: egg ratio were significantly (P<0.001) by genotype. TNN had higher chick weight and yield than F-α and NL chicks. In conclusion, F-α laid more eggs than others, exhibited higher fertility with longer chicks at hatch. TNN is superior in EWT, HU, IQU and chick yield. NL had higher SP than others.

Keywords: Egg production, Egg quality, FUNAAB alpha chicken, Hatchability, Transylvanian naked neck chicken.
Phytoremediation Of Crude Oil Impacted Soil Using Purple Nutsedge
Authors: Nwaichi E.O. , Chukwuere C.O. , Abosi P.J. , Onukwuru G.I.
Published: May 2021

The present study investigated the viability of purple nutsedge in the phytoremediation of a crude oilcontaminated land in the Kom-Kom community, Oyigbo, Rivers state, Nigeria. 150g of soil samples were randomly collected from two (2) different points on the polluted site and a control site and analyzed for Petroleum Aromatic Hydrocarbons (PAHs), Total Petroleum Hydrocarbons (TPH) and Heavy metals ( Pb, Cd, Cr & Ni). in soils and plants before and after phytoremediation. Plants were transplanted into the contaminated and contaminated soil after soil sample collection.After planting,the progress of plant growth was observed and recorded biweekly for 3 months before harvesting. From the results obtained, over 80% and 66% PAHs and TPHs phytodegradation efficiencies were achieved using the plant while Cd, Pb and Cr were removed by 90%, 67% and 39.2% respectively. The Bioaccumulation Factor (B.F) of the heavymetals in study plant were found to be greated than 1 which makes it suitable for phytoextraction of heavy metals. Therefore, the study suggests that purple nutsedge can be useful in the phytoremediation of a crudeoil polluted soil.

Keywords: Hydrocarbons, Heavy metals, Phytoremediation, Crude oil, Purple nutsedge