bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges in Implementing Competency-based Medical Education in India – Stakeholders’ Perspective: A Mixed-method Analysis
Authors: Sulena Sulena , Kulkarni Ashwin , Mathur Medha , Jyoti Naresh , Sidhu Tanvir Kaur , Badyal Dinesh , Guha Ranjit
Published: October 2024

Introduction:

Competency-based Medical Education (CBME) was introduced in the year 2019 in India. It has brought about major changes in medical education. The curriculum is learner centric, outcome based, focuses on the development of core competencies and professionalism. However, many institutions have faced challenges during the implementation of the CBME curriculum. This study was aimed at assessing the challenges faced by all the stakeholders (students, faculty, and administrators) of various medical institutions and gather their insights on proposed solutions.

Methodology:

This cross-sectional study was conducted over a period of 3 months, from October 1, 2023, to December 31, 2023. The study was conducted in 32 medical colleges across India. A total of 60 faculty of various disciplines, 32 administrators of the institutes, and 580 undergraduate medical students were included in the study. Perception of students and faculty was collected using a validated survey form. One-on-one interview was done for all the 32 administrators using a facilitator guide. A mixed-methods approach was used for quantitative and qualitative data collection and analysis.

Results:

Around 40 (66.6%) faculty opined that that deficiency of trained faculty was a significant challenge in implanting CBME curriculum. Twenty (33.3%) of the faculty felt that there is a lack of adequate infrastructure required for the implementation of CBME curriculum. Among the administrators surveyed, 12 (37.5%) felt that dwindling student attendance was a major challenge, whereas 10 (31.5%) felt that there was the lack of collaboration between universities, colleges, and regulatory authorities. Four hundred and twenty-five (73.2%) of students opined that simulation-based training and 435 (75%) students opined that electives were very good initiatives by CBME curriculum. The students found the inclusion of integrated teaching, Attitude, Ethics, and Communication Module, early clinical exposure, and Family Adoption Programme in the CBME curriculum helpful.

Conclusion:

CBME curriculum was largely accepted across all the medical colleges. The training of faculty and administrators was considered an important challenge which needs to be considered. Students opined that the newer curricular reforms enhanced their learning.
Initial application of near-infrared fluorescence imaging using indocyanine green in urethral reconstructive surgery
Authors: Putra Donny Eka , Satyagraha Paksi , Daryanto Besut , Adi Kuncoro
Published: October 2024

Introduction:

Near-infrared fluorescence (NIRF) imaging using indocyanine green (ICG) is increasingly being explored in various urological procedures, including urethral reconstructive surgery. This real-time technology assists surgeons in the visualization of critical anatomical structures, thereby potentially improving surgical precision and patient outcomes.

Objective:

This study aimed to report our preliminary experience using ICG technology in urethral reconstructive surgery using the SPY system by Novadaq.

Materials and Methods:

ICG technology was adopted in seven urethral reconstructive procedures performed in Saiful Anwar Hospital over 1 month in 2018. The procedures were performed by two surgeons, consisting of five excisions and primary anastomosis (EPA) and two substitution urethroplasties with real-time evaluation of ICG expression in corpus spongiosum intraoperatively.

Result:

The ICG solution was injected intravenously in all urethral reconstructive procedures. The ICG injection was allowed to visualize the corpus spongiosum in a matter of 30–60 s. The dosage of ICG used was 5 mg diluted in 10 mL of normal saline. One procedure had been converted from EPA to vascular-sparring anastomotic urethroplasty because of poor perfusion of the corpus spongiosum. All the procedures had good outcomes. No adverse and allergic reactions to ICG and other complications occurred postoperatively.

Conclusion:

Our preliminary experience confirmed the safety and efficacy of ICG technology in urethral reconstructive surgery. The main advantage of using NIRF imaging is allowing the surgeon to real-time evaluate corpus spongiosum qualitatively and quantitatively. The limitation is specific equipment needed like the SPY system by Novadaq.
Surgical replacement of the poorly draining dilated colon conduit urinary diversion in the neurogenic population: A single-center experience of two cases
Authors: Ratanawong John P. , Demzik Alysen , Elliott Sean P.
Published: October 2024

Colon is used instead of the typical ileum for urinary conduit diversion in select situations: (1) radiation ileitis, or (2) the “switcheroo” in patients with an existing colostomy or patients undergoing a simultaneous colostomy to avoid a bowel anastomosis. We describe our experience with two patients with spina bifida who underwent a “switcheroo” colon conduit for neurogenic bladder and, later, presented with complications due to distension of their conduit. Neurogenic bowel may lead to urinary stasis in the colon conduit and eventual upper tract complications. Conversion to an ileal conduit resolves these problems; we describe a surgical approach to converting a colon conduit to an ileal conduit.
Comparative Evaluation of Penetration Depth and Antimicrobial Efficacy of Calcium Hydroxide, MAS Paste, Nitrofurantoin, and Levonadifloxacin against Enterococcus faecalis: A Confocal Laser Scanning Microscopic Study
Authors: Gunnam Nishitha , Aravelli Swathi , Ramachandruni Nimeshika , Gandla Mounika , Kasam Swetha , Kumar Podugu Uday
Published: October 2024

Aim:

The most prevalent species in persistent and secondary infections linked to endodontic failure is Enterococcus faecalis. The objective of this in vitro investigation was to assess the antibacterial efficacy and penetration depth of calcium hydroxide, nitrofurantoin, levonadifloxacin, and a mixture of antibiotic and steroid paste (MAS paste) against E. faecalis.

Materials and Methods:

A total of 40 single-rooted tooth samples were decoronated apically and coronally to yield 10 mm root sections. All tooth samples were biomechanically prepared and were inoculated with E. faecalis bacteria for 21 days. The study involved four groups, each containing 10 teeth as follows: group 1—calcium hydroxide, group 2—MAS paste consisting of ciprofloxacin, metronidazole as antibiotics, and dexamethasone as corticosteroid, group 3—nitrofurantoin, and group 4—levonadifloxacin. For 7 days, the corresponding intracanal medications were injected into the canals. On the seventh day, dentinal debris was extracted from the blocked lumen to quantitatively evaluate the antibacterial activity of the experimental medications. The depth of penetration (DOP) of medicaments under study was assessed by viewing 1 mm thick horizontal sections under a confocal laser scanning microscope, one from each of the four subgroups. The sections were stained with florescent stain before being under the microscope.

Results:

Results showed that on day 7, the mean colony-forming units were lowest for levonadifloxacin, indicating the highest antimicrobial efficacy (P < 0.05). This was followed by nitrofurantoin, MAS paste, and calcium hydroxide. Additionally, levonadifloxacin achieved the greatest DOP, followed by nitrofurantoin, MAS paste, and calcium hydroxide. These results suggest a correlation between DOP and antimicrobial efficacy.

Conclusion:

Within the confines of this study, it can be concluded that levonadifloxacin exhibited the highest antimicrobial efficacy, even at a low concentration of 8 µg/mL. Therefore, it can serve as a viable intracanal medicament in endodontic therapy.
Bibliometric Mapping of the Scientific Production of Lasers in Endodontics: Collaborative Networks, Impact, and Trends
Authors: Vargas-Lindo Suleika , Cárdenas-Cueva Diani , Tinedo-López Pedro Luis , Espinoza-Carhuancho Fran , Pacheco-Mendoza Josmel , Mayta-Tovalino Frank
Published: October 2024

Aim:

The objective of this study is to perform a bibliometric mapping of the scientific production of lasers in endodontics using collaborative networks, impact, and trends.

Materials and Methods:

This retrospective and descriptive study used a bibliometric design to analyze laser use in endodontics in Scopus from 2018 to 2024. In total, 877 documents were identified using key terms and MeSH. Bibliometric indicators were used to explore scientific activity and impact, and VOSviewer was used for data analysis.

Results:

It was found that the year with the highest number of publications was 2023, with 166, and the quartiles with the highest productivity were Q1 (40.3%) and Q2 (31.1%). Among the top 5 countries with the highest publications production, Brazil led the group with 125, followed by India (111). Among the institutions with the highest production, the Universidade de São Paulo tops the list with 51 research papers, closely followed by the Tehran University of Medical Sciences with 32 and the Universidade Estadual Paulista Júlio de Mesquita Filho with 30. Among the most outstanding authors, we have Chiniforush Nasim, who has 20 papers; however, Duarte Marco has an h-index of 48, and Sivieri-Araújo Gustavo has the highest number of citations.

Conclusion:

This bibliometric mapping reaffirmed the vision and trends of lasers in endodontics, with 2023 being the most relevant in terms of scientific production and, among the countries with the highest number of publications, Brazil stood out.
Quantitative Analysis of Tooth-Whitening Efficiency Using Natural Bleaching Agents: An In Vitro Spectrophotometric Evaluation
Authors: Tan Pei Ying , Narayanan Asha Sharma Pusnaa S. , Tay Kit Ken , Nor Azmi Nuruljannah , Yap Yeannie Hui-Yeng
Published: October 2024

Aim:

While conventional whitening agents provide effective color change, concerns linger regarding enamel health. This study explored the potential of natural alternatives for coffee stain removal on extracted teeth, aiming to identify safe and efficacious options for patients seeking noninvasive bleaching solutions.

Materials and Methods:

This study employed 50 extracted permanent anterior teeth divided into five groups (negative control, positive control, strawberry, pineapple, and honey). Standardized coffee staining was applied to all teeth followed by 3 weeks of twice-daily treatment with their respective solutions. Shade changes were measured objectively using a Konica Minolta Spectrophotometer CM-5 at baseline and after 1, 7, 14, and 21 days post-treatment. Statistical analysis was conducted with Kruskal–Wallis and Tukey post hoc tests (IBM® SPSS®).

Results:

Strawberry juice exhibited equivalent ΔE (color change) compared with 35% hydrogen peroxide (P > 0.99), indicating similar stain removal efficacy. Both pineapple juice and honey solution displayed significantly lower ΔE values compared with the control and strawberry juice groups (P = 0.002 and <0.001, respectively), suggesting limited bleaching capability.

Conclusion:

This study demonstrates the potential of strawberry juice as a viable alternative to conventional bleaching agents, offering comparable stain removal efficacy on coffee-stained teeth and further highlighting the need for further research on their effectiveness in clinical settings. Meanwhile, pineapple juice and honey solution exhibited limited bleaching potential. These findings contribute to the expansion of safe and potentially noninvasive teeth-whitening options.
Trends and Patterns of Endodontic Therapy in Primary Teeth: A Visualized Bibliometric Analysis of Research Output in Saudi Arabia
Authors: Mirah Mahir A. , Hamadallah Hatem H. , Madkhaly Mohammad A. , Sharqawi Abdulwadood J. , Altarjami Ammar A.
Published: October 2024

Aim:

To analyze research trends and collaboration patterns in endodontic therapy of primary teeth in Saudi Arabia using bibliometric analysis.

Materials and Methods:

A search was conducted in the Web of Science database on March 1, 2024, to identify relevant publications. A total of 54 articles were retrieved and ranked according to citation counts. The key indices contain total citation counts, h-index, and publication counts. The analysis used Biblioshiny (Bibliometrix R package) and VOSViewer to show the collaboration networks and publication trends. Two reviewers were used for extraction to ensure validity and reliability.

Results:

The bibliometric analysis showed an increase in research output and citations, with peaks in 2020 and 2023. King Abdulaziz University and King Saud University were the leading institutions in this field, with the most publications and extensive collaboration networks. The most highly cited article was published by Bawazir OA in 2006, which was about root canal obturation methods in primary teeth. The keyword used most was “Mineral trioxide aggregate.” The key journals in this field were Pediatric Dentistry and the Saudi Dental Journal.

Conclusion:

This study confirms the emergence of Saudi Arabia as a significant contributor to research in primary tooth endodontics, demonstrating increasing scholarly impact and academic interest in this field. The results highlight the country’s growing role on the global research stage. Collaboration patterns suggest that this positive trend is likely to enhance impactful collaborative research in the future.
Clinical Performance Evaluation of Ambu AuraGain versus I-gel in Obese Female Patients Undergoing Short-duration Surgeries for Breast Cancer: A Randomised Controlled Trial
Authors: Mitra Suparna , Banerjee Sumantra Sarathi , Debroy Debashis , Nandi Rudranil , Rudrapal Angshuman , Goswami Jyotsna
Published: October 2024

Background and Aims:

Supraglottic airway devices (SADs) secure and maintain airways in patients undergoing breast cancer surgery. I-gel and Ambu AuraGain (AAG) are two common second-generation SADs used. However, data comparing their efficacy are limited in adult obese breast cancer patients. This study was planned with the primary objective of comparing the oropharyngeal leak pressure (OLP) of these two SADs at 1 min after insertion.

Methods:

A total of 80 patients scheduled for breast cancer surgery were recruited and randomised into two groups: Group A (AAG) and Group I (I-gel). The insertion time of the SADs, the number of insertion attempts, the OLP at 1 min after insertion, the ease of insertion, the fibre-optic bronchoscopy view (FOB), the ease of suction catheter placement, additional manipulation during insertion and maintenance, the OLP at 30 min after insertion and complications, etc., were assessed.

Results:

OLP was significantly higher (P < 0.05) in Group I compared to Group A at 1 min and 30 min after the SAD placement. Ease of insertion and FOB view score were significantly better in Group I than in Group A (P < 0.05). Moreover, patients in Group A reported a higher incidence of sore throat compared to Group I patients (P < 0.05).

Conclusion:

The I-gel demonstrated superior sealing pressures and mitigated sore throat significantly compared to the AAG in obese female patients undergoing breast cancer surgery. Furthermore, as confirmed by FOB, its enhanced perilaryngeal positioning underscores its efficacy over the AAG in this patient demographic.
Evolving Strategies of Acute Post-operative Pain Management Service across Three Time Periods – A Single-centre Retrospective Analysis
Authors: Sarkar Anshuman , Haldar Srimanta Kumar , Banerjee Sumantra Sarathi , Nandi Rudranil , More Shikhar , Pal Angshuman Rudra , Burman Suparna Mitra , Goswami Jyotsna , Bose Shiladitya
Published: October 2024

Background and Aims:

Pain alleviation is essential to enhanced recovery after surgery. In India, the acute pain service (APS) is still not well organised, and there is a wide variation in practices. In this retrospective cohort study, we have aimed to analyse how introducing a structured APS and its subsequent evolution with time has affected the pain scores of our post-operative patients undergoing major abdominal oncosurgeries.

Methods:

All adult patients who underwent elective major open abdominal oncosurgeries in our institution during the three time periods based on different levels of APS development: Timeline-1 (April 2021–September 2021), Timeline-2 (April 2022–September 2022) and Timeline-3 (January 2023–June 2023) were included, and data on post-operative dynamic pain scores were collected. The pain service delivery was reorganised, and from January 2021 onwards, there was an evolution from once-daily pain rounds to twice-daily pain rounds, facilitated by including a designated pain nurse and further refinement to include pre-operative patient education and staff training. The data were collected and analysed for change in various outcomes related to APS and its outcomes.

Results:

A total of 936 patients were included in the study. A statistically significant decline in dynamic pain scores was observed over time. Subgroup analysis conducted according to the extent of surgical incision revealed significant declines in dynamic pain scores over time.

Conclusion:

The study underscores the significance of a structured APS in optimising post-operative outcomes and highlights the need for continued efforts to enhance acute surgical pain management practices in healthcare settings.
A Comparative Study between Epidural Morphine Bolus and Ropivacaine-fentanyl Infusion in Gastrointestinal Oncosurgeries: A Randomised Clinical Trial (MORFIN Study)
Authors: Nandi Rudranil , Haldar Srimanta Kumar , Mitra Suparna , More Shikhar , Sarkar Anshuman , Goswami Jyotsna , Roy Bipradas
Published: October 2024

Background and Aims:

Epidural local anaesthetic infusion is the gold standard analgesia technique after abdominal surgery. However, hypotension associated with it often leads to the administration of large amounts of fluid, increased vasopressor requirement, reduction of epidural drug dose and thus increased intravenous opioid consumption. Epidural morphine can be an alternative technique.

Methods:

Eighty-six patients scheduled for open elective gastrointestinal (GI) oncosurgery were enroled in the study. In Group ROP, analgesia was provided with a 6 ml bolus of epidural ropivacaine (0.2%)-fentanyl (2 µg/ml) followed by an infusion at 3–10 ml/h during the perioperative period. In Group MOR, a bolus of epidural morphine 0.05 mg/kg in 10 ml bupivacaine 0.1% was administered every 8–24 h. In both groups, rescue analgesia was provided with intravenous fentanyl. The primary outcome of the study was to compare post-operative fentanyl consumption between the two groups.

Results:

Mean ± standard deviation (95% confidence interval) fentanyl consumption was significantly lower in Group MOR in the first 24 h (92 ± 191 [33, 151] vs. 255 ± 263 [173, 338] µg in Group ROP; P < 0.01), 24–48 h (71 ± 203 [9, 134] in Group MOR vs. 261 ± 357 [150, 372] in Group ROP; P < 0.001) and 48–72 h (51 ± 168 [0, 103] in Group MOR vs. 240 ± 319 [140, 339] in Group ROP; P < 0.001) in the post-operative period. Pain scores at rest and during movement were significantly lower in group MOR in the immediate post-operative period. The post-operative fluid requirement in the first 24 h was also significantly lower.

Conclusion:

Intermittent boluses of epidural morphine with low-dose bupivacaine are associated with lesser post-operative fentanyl consumption compared to epidural ropivacaine-fentanyl infusion after GI oncosurgery.
Complex of Hybrid Diabetes Mellitus With Severe Insulin Resistance and Cerebrovascular Complications: A Case Report
Authors: Shah Pranjali
Published: October 2024

Some type 1 diabetes mellitus (T1DM) patients develop features of insulin resistance, typically seen in type 2 diabetes mellitus, leading to a condition termed hybrid diabetes mellitus (HDM). We present a case of a 30-year-old female diagnosed with HDM and cardiovascular complications. She had a history of T1DM from the age of 7 years and presented with acute right-sided limb weakness. She had comorbidities, including hypertension, polycystic ovarian syndrome, hypothyroidism, and a high Body Mass Index (37 kg/m2). Initial evaluations revealed elevated blood pressure, pulse rate, thrombocytosis, homocysteine level, and hemoglobin A1c. Magnetic resonance imaging showed a completely blocked carotid artery and cardiological assessments indicated mild left ventricular hypertrophy and diastolic dysfunction. Glutamic acid decarboxylase antibodies were positive, and C-peptide was absent, confirming T1DM with insulin resistance HDM. Treatment involved anticoagulants, antiplatelets, statins, and supportive care. The patient showed significant clinical improvement, although surgery was not viable due to completely blocked vessels.
Real-World Effectiveness of Oral Semaglutide in Indian Adult Diabetic Patients: Evaluation of EMR-based Data
Authors: Gudibanda Sandeep , Govardhane Sharayu , Kaloo Supriya , Shah Snehal , Miglani Vaibhav , Verma Garima
Published: October 2024

Introduction:

Diabetes is increasingly becoming a significant health concern globally, including in India, where its prevalence continues to increase. Being overweight often acts as a catalyst for developing diabetes, exacerbating the condition and increasing the risk of other serious health complications such as heart disease, kidney problems, and nerve damage. Peptide-based molecules like semaglutide have proved their efficacy in controlling glycated hemoglobin (HbA1c) levels and body weight in diabetic patients.

Objective:

The present study aims to determine the effectiveness of oral semaglutide in a real-world setting.

Materials and Methods:

This retrospective study included patients ≥18 years of age prescribed oral semaglutide with a follow-up visit between 80 and 160 days post-prescription and had baseline body mass index (BMI) ≥ 30 kg/m2 and HbA1c levels ≤10.0%. The primary endpoints were to assess changes in HbA1c level, BMI, and body weight from the baseline. The secondary endpoints were to determine the changes in postprandial blood sugar (PPBS), fasting blood sugar (FBS), and blood pressure. The analysis also encompassed data on comorbid conditions and concomitant medications prescribed.

Results:

A total of 188 patients met the study eligibility criteria. At the follow-up visit, a statistically significant mean reduction of 0.34% in HbA1c levels and a weight loss of 1.83 kg were observed. The average duration between baseline and follow-up visit was 114.14 ± 21.5 days. The mean reduction in the BMI was 0.73 kg/m2 (P < 0.001). During the follow-up visit, the PPBS level decreased by 9.95 mg/dL and the FBS level decreased by 5.02 mg/dL. Additionally, the effect of semaglutide on blood pressure was evident, with a reduction in systolic blood pressure by 1.69 mm Hg and diastolic blood pressure by 1.30 mm Hg. The most common comorbid condition was dyslipidemia (66.49%), followed by hypertension (51.60%) and obesity (39.36%).

Conclusion:

Semaglutide demonstrated significant reductions in glycemic parameters, body weight, and blood pressure.
Vitamin D Deficiency Prevalence in Pakistan: Common, Important, and Neglected: A Comprehensive Meta-Analysis
Authors: Mahar Benazir , Shah Tazeen , Sadiq Noman , Mangi Rozina , Warsi Jamshed , Abbas Qamar
Published: October 2024

Vitamin D is crucial for normal body metabolism. Two important vitamin D sources are synthesis in the lower layers of the skin (90%) and diet (10%). This systematic review and meta-analysis attempted to determine the incidence of vitamin D deficiency in Pakistan by using the findings of numerous cross-sectional studies. For subgroup analysis, a population-based subgroup analysis and a geographical location-based subgroup analysis were done. Different search techniques were utilized on various databases using the terms “vitamin D deficiency,” “Pakistan,” and “prevalence.” The article names and abstracts were scrutinized, and associated complete texts were evaluated. The articles that satisfied the inclusion requirements were chosen for the meta-analysis. The I
2 test was used to determine heterogeneity. They were combined with the random-effect method. Out of 429 articles, 37 studies, with a total sample size of 19,338, were selected for the final analysis. The highest and lowest reported percentages observed were 100% and 15%, respectively. The overall pooled prevalence reported was 78% (95% CI = 74.2–82%). In subgroup analysis, children/adolescents showed a higher pooled prevalence of 84% (95% CI = 76.1–93.6%), and among province-wise subgroup analysis, Punjab province has shown a higher pooled prevalence of 84% (95% CI: 74–94%). Meta-analysis of the data showed a higher proportion of the population with deficient states. Interventions in public health are essential to address the high incidence of vitamin D insufficiency. Vitamin D levels can be increased, and related health concerns can be minimized through dietary supplementation, recommended sun exposure, and awareness initiatives.
The Application of Case-Based Learning (CBL) Combined with PDCA Cycle in the Clinical Teaching Practice of Breast Ultrasound in Standardized Residency Training
Authors: Wu Y , Zhou Q , Ju X , Zhang H
Published: October 2024

Background:

The integration of case-based learning (CBL) with the plan-do-check-act (PDCA) cycle has potential benefits for clinical education, yet its efficacy in ultrasound residency training, particularly for breast ultrasound, requires evaluation.

Aim:

This study aimed to assess the impact of a combined CBL and PDCA cycle teaching model on the clinical thinking and skills of ultrasound residents compared to traditional teaching methods.

Methods:

A comparative study was conducted at Sichuan Provincial People’s Hospital’s ultrasound medicine base, from August 2020 to June 2023, focusing on residents in training. Sixty-one trainees were randomly divided into two groups: a joint group (n = 31) taught using a PDCA cycle-based model integrated with CBL and a traditional group (n = 30) taught with conventional methods. Both groups underwent a 20-hour course and were subsequently evaluated on theoretical knowledge, clinical thinking, and skills. Comparative statistical analysis was performed to evaluate the performance differences between the two groups.

Results:

The joint group demonstrated significantly better clinical thinking and skills operation than the traditional group (P < 0.05). No significant difference was observed between the groups regarding theoretical knowledge (P > 0.05).

Conclusions:

The combined CBL-PDCA cycle teaching mode significantly enhances the clinical thinking abilities and operational skills of residents in breast ultrasound training. This innovative approach shows promise as an effective educational strategy to foster intrinsic motivation and higher order learning capabilities among ultrasound residents.
Personalized Food Avoidance Dietary Approach for Psoriasis and Hypertension: A Case Study and Pilot Trial
Authors: Chijioke CP , Okafor MT , Nubila NI , Onah IC , Chijioke UO , Chigbo NN , Maduka IC , Udoh IP , Eleazar CI , Gbenimachor NM , Mbadiwe NC , Nwadike KI , Anusiem CA , Nwosu NI , Okpe AC , Muobike AT , Nwokolo BA , Udorah MI , Nnadozie OJ , Nwonu PC , Ndiokwelu CI , Okwara CC , Oji LC , Okoli UA , Uamai IM , Anakwue RC , Amah CC , Ironkwe NF , Ekwe EA , Aniagor EN , Ayuk CO , Aneziokoro EA , Onwasigwe CN , Ugwoke U , Ide C , Effiong-Essien CR , Chima-Enema N , Onyia BU , Okwy-Nweke C , Enuka HC , Onwuka-Kalu N , Obiefuna A , Okpara TC , Maduabuchi JU , Okwara CC
Published: October 2024

Background:

The comorbidity, coheritability and common immune pathways of the inflammatory ‘chronic’ (non-communicable) diseases, suggest a shared aetiopathogenic mechanism, with phenotypic localization dependent on genetic predisposition, for example, the arteries in hypertension and the skin in psoriasis. Lifelong observation of psoriasis suggests genetically predisposed toxicity of amphiphilic fats, flavor enhancers, and nonsugar sweeteners.

Aim:

To conduct trials of personalized dietary intervention to abate the phenotypic expression of psoriasis and hypertension.

Materials and Methods:

The interventional case study of psoriasis was conducted by means of repetitive dietary challenge and avoidance testing. We then conducted an open trial of personalized nutrition on nine consenting recruits with uncomplicated essential hypertension. They were counseled on which foods to avoid or to take based on the experience gained in psoriasis. Study participants with ‘GOOD’ or ‘FAIR/POOR’ dietary compliance were compared with regard to blood pressure (BP) control, antihypertensive drug treatment requirement (ADTR), and anthropometry.

Results:

Data from four FAIR/POOR diet compliers and three GOOD compliers, as at 29 weeks of dietary intervention, showed mean systolic home BP values of 128.1 (±6.74) mmHg and 122.3 (±2.03) mmHg, respectively; the mean systolic automated office BP values were 139.8 (±8.80) mmHg and 108.3 (±5.55) mmHg, respectively; as at 39 weeks of dietary intervention, the mean ADTR scores were 4.2 (±2.12) and 1.03 (±0.57), respectively. Using data at baseline and from all available timepoints after dietary intervention, two-way ANOVA confirmed highly significant improvement of BP control (P < 0.0001) and reduction of ADTR score (P = 0.0008) in GOOD compliers. GOOD compliers exhibited significantly more reductions in BMI, abdominal circumference, and triceps skinfold thickness than FAIR/POOR compliers (two-way ANOVA and linear regression: P < 0.05).

Conclusion:

These results support the case for adverse dietary exposure avoidance to abate the phenotypic expression of chronic disease.
Effect of Glucosamine Hydrochloride Combined with Celecoxib on Inflammatory Response and Bone Metabolism in Patients with Knee Osteoarthritis
Authors: Zhang C , Mu S , Wang L , Yang Z , Sun Y
Published: October 2024

Background:

Knee osteoarthritis is one of the common chronic degenerative joint diseases. The present study explored the efficacy of glucosamine hydrochloride combined with celecoxib in the treatment of knee osteoarthritis and its effect on inflammatory response and bone metabolism.

Material and Methods:

Ninety patients with knee osteoarthritis were randomly divided into the single treatment group and the combined treatment group, which received the treatment using single glucosamine hydrochloride and glucosamine hydrochloride combined with celecoxib for three months, respectively.

Results:

After treatment, compared with the single treatment group, in the combined treatment group the total effective rate was increased, the Visual Analogue Scale score was decreased, the Lysholm score was increased, the serum tumor necrosis factor-α, interleukin 6 and interleukin 1β levels were decreased, the serum β-C-telopeptides of type I collagen level was decreased, and the serum bone-specific alkaline phosphatase and osteocalcin levels were increased. The incidence of adverse reactions during treatment had no significant difference between two groups.

Conclusions:

Glucosamine hydrochloride combined with celecoxib has a good therapeutic efficacy for patients with knee osteoarthritis, and it can improve the bone metabolism and reduce the inflammatory response in patients.
A Retrospective Cohort Study of the Clinical Presentation and Visual Outcomes of Blepharoptosis Treatment
Authors: Atima MO , Idakwo U , Komolafe O , Shimizu E , Shintaro N , Balogun EO , Dingwoke EJ , Orugun AJ , Atima-Ayeni E , Yetunde AF , Jah PD
Published: October 2024

Background:

Blepharoptosis (ptosis) is the drooping of the upper eyelid, which can be congenital or acquired and caused by various factors. It can lead to vision impairment, such as amblyopia in children, and reduced visual fields in adults, affecting quality of life.

Aim:

To analyze the clinical manifestation of ptosis, specifically examining the available treatment options and evaluating the resulting visual outcomes.

Methods:

A comprehensive analysis was conducted on the medical records of patients diagnosed with ptosis who received treatment through both surgical and non-surgical approaches between January 2017 and December 2020. Additionally, an examination of the underlying factors contributing to the condition was performed and presented.

Results:

A total of 28 patients, with an average age of 31.48 ± 21.66 years, received treatment at our facilities. Out of the 26 cases of unilateral ptosis, 11 patients (43%) underwent surgery, while 15 patients (57%) were treated with medications. The majority of the surgical cases were due to congenital ptosis (8 patients), followed by traumatic ptosis (3 patients). Among the patients who did not undergo surgery, neurological ptosis was present in 6 cases, while congenital ptosis was observed in 5 cases. All cases were successfully managed, resulting in good visual acuity and no complications.

Conclusion:

The most prevalent type of ptosis is congenital ptosis, which primarily affects males and tends to occur more frequently in the left eye. In acquired cases, traumatic ptosis is the most commonly observed type according to this study. After undergoing surgery, patients with congenital ptosis experienced improved visual outcomes, displaying good cosmetic appearance and achieving a visual acuity of 6/6-6/18.
Evaluation of different methods for optic port entry in the umbilical region in gynecologic laparoscopic operations
Authors: Shrief Basma M. , Borg Hesham E.S. , Awara Ahmed M. , El Naggar Ramy M.
Published: October 2024

Background

Scarring after surgery poses a significant concern for women, particularly for those in their youth.

Aim

Evaluate which method of vertical trans umbilical and tranverse supra umbilical entry approaches in laparoscopic surgeries ought to be prioritized regarding cosmetic, pain and infection.

Patients and methods

This prospective comparative study was performed on 50 individuals aged from 18 to 60 years old, both sexes, undergoing diagnostic or operative laparoscopy for infertility, ovarian torsion, or cystectomy, chronic pelvic pain and total laparoscopic hysterectomy. Participants divided in to two groups equally: group 1: Vertical trans umbilical incision. Group 2: Transverse supra umbilical incision.

Results

There were significantly lower pain scores and overall scar scores after 1 week, 1 month, and 3 months of the operation in individuals with vertical trans umbilical incision than in patients with transverse supra umbilical incision. A substantial variation existed among both groups as regard redness warmth, tenderness, and increased pain. There was significantly lower vascularity, pigmentation, pliability, thickness sub scale scores, and overall scar scores after 1 week, 1 month, and following 3 months of the operation in individuals with trans umbilical vertical incision than in patients with supra umbilical transverse incision (P<0.05). Lower painful, itchy, stiff, irregular, and hyperpigmented scar in vertical trans umbilical incision than patients with transverse supra umbilical incision however, this difference was significant in itching and irregular scar formation (P<0.05).

Conclusion

A vertical incision provides better cosmetic outcomes compared with a transverse incision one.
Extreme events and ichthyofauna: case report of a neotropical river
Authors: Smith Welber Senteio , Paiva Flavia Conceição de , Carvalho Luis Gustavo Nogueira de , Alves Natalia Silva , Lima Talita Rolim de Freitas , Santos Thiago Mündel Ribeiro , Bento Camila Silva
Published: October 2024

The increasing frequency and intensity of extreme weather events and their impact on aquatic ecosystems and fish species is concerning. This manuscript reports and analyzes two events, a drought in 2019 and a flood in 2024, providing valuable insights into the consequences of these events. The rescue of 269 individuals of 19 fish species during the 2019 drought highlights the significant impact of the extreme conditions on the ichthyofauna. Rising temperatures, isolation, and habitat fragmentation must have posed severe challenges for the fish species during this period. On the other hand, the observation of 53 dead individuals of 5 species during the 2024 flood indicates the detrimental effects of this event on the fish population. The association of mortality and dispersal of several species with the existing dam further underscores the complexity of the challenges faced by fish during extreme flood events. The correlation between rainfall, river regime, and the impact of land use and occupation provides an important context for understanding the dynamics of these extreme events. The low rainfall during the 2019 drought and the gradual increase in rainfall between 2022 and 2024 leading to the flood demonstrate the significant role of precipitation patterns in shaping the outcomes for fish species. Additionally, the analysis of land use and occupation, particularly the substantial increase in urbanization in the drainage basin over the last 30 years, highlights the human-induced factors contributing to the stress on aquatic ecosystems. Both extreme floods and droughts have significant implications for fish species. Extreme floods can alter riverbeds, cause direct mortality, and disrupt isolated populations, while extreme droughts can lead to fish kills, and habitat fragmentation, and exacerbate environmental stressors. This analysis emphasizes the urgent need for comprehensive measures to mitigate the impact of extreme weather events on aquatic ecosystems and fish species. Addressing factors such as land use and occupation, water management, and climate change adaptation strategies is crucial for promoting the resilience of fish populations in the face of ongoing environmental challenges.
Keywords: drought, Ipanema National Forest, rainfall.
Spectrophotometric determination of procaine hydrochloride using oxidative coupling and cloud point extraction
Authors: Salah Qadir Gulan , Sabeeh Othman Nabeel , Thanoon Al-Taee Amer
Published: October 2024

A method with rapid, sensitive, accurate, and selective for estimation of local anesthetic procaine hydrochloride (PRO.HCl) is crucial, due to its bad damage to health if administrated excessively. In this work two spectrophotometric methods oxidative coupling and cloud point extraction (CPE) were utilized for determination of PRO.HCl in its standard state and pharmaceutical preparations. Method A, based on the oxidative coupling reaction using sodium hypochlorite as an oxidant and 2,5-dimethylphenol as coupling agent. The blue colored product has high absorption at 600 nm. Method B based on the CPE relying on the previous reaction, with addition of Triton X-114, after extracting the colored product, it was measured at 630 nm. Beer’s law of both methods are linear in the concentration ranges 2.50-50 µg/mL (method A) and 1.25-3.75 µg/mL (method B). The molar absorptivity coefficients of methods (A) and (B) are 4.01 x 103 and 1.34 x 104 L/mol.cm, respectively. For (method A) limit of detection and limit of quantification were calculated and found that 0.26 µg/mL and 0.87 µg/mL, respectively, while for (method B) were found to be 0.16 and 0.54 µg/mL, respectively. Both methods (A and B) are applied to evaluate PRO.HCl in pharmaceutical preparations (injection).
KEY WORDS: Cloud point extraction, 2,5-Dimethylphenol reagent, Odxiative-coupling, Procaine-hydrochloride, Spectrophotometry, Triton X-114.
Bull. Chem. Soc. Ethiop. 2025, 39(1), 1-13.                                                                 
DOI: https://dx.doi.org/10.4314/bcse.v39i1.1
Synthesis, characterization, biological activity, DFT and Hirshfeld surface studies of Pd(II) and Pt(II)-1-cyclohexyl-3-phenylthiourea and amine ligands
Authors: H Khalaf Wesam , A. Al-Jibori Subhi , Ashfaq Muhammad , S. Faihan Ahmed , Nawaz Tahir Muhammad , S. M. Al-Janabi Ahmed
Published: October 2024

A series of mixed ligand complexes of Pd(II) and Pt(II) of 1-cyclohexyl-3-phenylthiourea and diamine ligands {2,2'-bipyridyl (Bipy) and 1,10-phenanthroline (Phen)} were prepared and characterized by FT-IR, NMR spectroscopy, molar conductivity. Density functional theory (DFT) calculations and biological activity were carried out on the prepared complexes. In vitro antimicrobial activity was investigated against three pathogenic bacteria (Staphylococcus aureus, Bacillus cereus and Escherichia coli). The most active compound 6 was found more active than free ligand and other complexes. The crystal structure of the free ligand was determined by X-ray diffraction (XRD) analysis. Hirshfeld surface analysis was executed for the free ligand by finding and exploring the interatomic contacts that are important considering the supramolecular assembly of the crystal. The mechanical stability or response is prophesied by voids analysis. The supramolecular assembly is significantly uncovered by intermolecular interaction energies calculations performed at   of the B3LYP/6-31G(d,p) electron density level.
KEY WORDS: Thiourea, Diamine, Crystal structure, DFT, Hirshfeld surface
Bull. Chem. Soc. Ethiop. 2025, 39(1), 15-27.                                                                
DOI: https://dx.doi.org/10.4314/bcse.v39i1.2
Haematological effect of a bi-herbal composition on phenyl hydrazine-induced anaemia in Albino Wistar rats
Authors: Obazelu P.A. , Odionyenma U.C.
Published: October 2024

Picralima nitida and Cymbopogon citratus are plants known for their anti-inflammatory, antioxidant, and haematopoietic properties. This study aimed to determine the haematological effect of a dual herb composition of these plants on phenylhydrazine-induced anaemia in albino Wistar rats. Sixty adult male rats were divided into six groups: control, phenylhydrazine group, ferrous sulphate group, and three groups receiving phenylhydrazine plus 100 mg/kg, 200 mg/kg, and 400 mg/kg of the extract. Haematological parameters were measured using an autoanalyzer and analyzed with SPSS software V22. The red blood cell count was significantly higher in the control group compared to other groups (p<0.05). Haemoglobin was significantly higher in the control, ferrous sulphate, 100 mg/kg, and 400 mg/kg groups compared to the phenylhydrazine and 200 mg/kg groups (p<0.05). Mean cell volume was significantly lower in the control group compared to all other groups (p<0.05). Mean cell haemoglobin was significantly lower in the control group compared to other groups while MCHC was higher in the control group compared to phenylhydrazine, ferrous sulphate, 100mg/kg and 200mg/kg groups (p<0.05). RDWSD was significantly lower in the control group compared to all other groups (p<0.05). Total white blood cell count was significantly lower in the control and phenylhydrazine groups compared to others (p<0.05). Lymphocyte was significantly higher in the ferrous sulphate group compared to others, while monocyte count was significantly lower in the control, phenylhydrazine, and ferrous sulphate groups (p<0.05). Neutrophil was significantly higher in the control and phenylhydrazine groups (p<0.05). Platelet was significantly lower in the control group compared to ferrous sulphate, 200 mg/kg, and 400 mg/kg groups (p<0.05). Mean platelet volume was significantly lower in the control, phenylhydrazine, ferrous sulphate, and 100 mg/kg groups compared to the 400 mg/kg group (p<0.05). The study concludes that the biherbal formulation of the plants caused significant alterations in haematological parameters.
Upper convected Maxwell fluid in an isothermal flow with thermal radiation
Authors: Idowu Sabiki Adebola , Usman Mustapha Adewale , Pete Benjamin Aina , Sikiru Akeem Babatunde , Ayeni Sheriffat Taiwo
Published: October 2024

In this research paper, a mathematical model of the isothermal flow of upper convected Maxwell (UCM) fluid with thermal radiation through a saturated porous media was studied in detail, with different physical parameters being considered. Maple 18 software is used to implement this strategy. The analysis of the results showed that the flow system was significantly influenced by the Schmidt, Darcy, and Deborah numbers, the unsteadiness parameter, the Maxwell parameter, the magnetic field parameter, and other physical characteristics. The influence of several physical characteristics on the flow system are discussed and shown graphically.
Equilibrium points and locations in the photogravitational circular Robe’s restricted three-body problem with variable masses
Authors: Leke Oni , Clement Masankari
Published: October 2024

The restricted three-body problem (R3BP) defines the dynamics of an infinitesimal mass moving in the gravitational neighborhood of two primaries, which move in circular orbits around their center of mass on account of their mutual attraction and the infinitesimal mass not influencing the motion of the primaries. In this paper, we examine equilibrium points and their locations in the photogravitational circular Robe’s restricted three-body problem (R3BP) with variable masses. The motion of the primaries and variation in masses of the primaries are governed by the Gylden-Mestschersky problem (GMP) and the unified Mestschersky law (UML), respectively, while the second primary is assumed to be a radiation emitter. The non-autonomous equations of the governing dynamical system are deduced and transformed using the Mestschersky transformation (MT), the UML and the particular solutions of the GMP, to a system of the autonomized equations with constant coefficients under the condition that there is no fluid inside the first primary. Next, the equilibrium points (EPs) of the autonomized system are explored using perturbation method and it is seen that axial EP which is defined by the mass parameter and the radiation pressure of the second primary exists. Further, a pair of non-collinear EPs which depends on the mass parameter, radiation pressure of the second primary and a constant of the mass variations of the primaries, is found. The EPs of the non-autonomous system are obtained using the MT and differ from those of the autonomized system by time t . The EPs may be used in different problems of stellar dynamics, and also in other astrophysical applications.
Uncovering the silent epidemic: Insulin resistance and some associated risk factors among pregnant women with gestational diabetes mellitus (GDM) in a low resource setting
Authors: Muhammad Yahaya , Kani Yamuna Aminu , Yandutse Mahmud Inusa , Musa Badamasi , Armaya’u Ahmed , Ibrahim Jamila Sulaiman , Habib Abubakar Abba , Tahir Abdulrahman , Muhamma Kabir , Abubaka Khadija , Bala Auwal
Published: October 2024

The present study sought to identify insulin resistance and related risk factors in pregnant women with gestational diabetes mellitus (GDM). One hundred and eighty-one pregnant women (34 with GDM and 147 without GDM) participated in the study. GDM screening involved a 75g OGTT test, while a structured questionnaire was used to gather socio-demographics data, and HOMA IR was used to assess insulin resistance. The study identified a 19.2% prevalence of GDM. Multiple regression analysis revealed that the studied risk factors accounted for 94% of GDM development. Additionally, the ROC curve demonstrated the wealth index as a significant factor for GDM development. The study found a high prevalence of GDM among pregnant women in low-resource settings, highlighting the need for targeted interventions to address the elevated occurrence. Socioeconomic factors such as low income and education were found to increase the risk of GDM
Land Governance and Environmental Management in the Middle East and North Africa (MENA) Region
Authors: Home Robert
Published: October 2024

The importance of governance arrangements for access, use and control of land and resources is being increasingly recognized by international institutions. This paper overviews land governance initiatives being promoted by UN Habitat, and the growing importance of rapidly developing geospatial technologies. The paper next addresses land governance issues in the MENA region, particularly the Arab Land Governance initiative, and presents a brief case study of Oman’s land governance, and its effects upon society, urban settlement patterns, and land markets. Issues of education and training for better land governance are discussed. Recommendations and conclusions address the issues and ways forward for the region.