bluuebunny/crossref_metadata_2025 huggingface dataset:
Excess mortality in Northeast Iran caused by COVID-19
Authors: Esmaeilzadeh Nayereh , Hoseini Seyed Javad , Nejad-Bajestani Majid Jafari , Shakeri Mohammadtaghi , Mood Zahra Izadi , Hoseinzadeh Hamidreza , Dooghaee Mohammad Hasan Derakhshan
Published: October 2023

Objective:

To make evidence-based decisions based on broad mortality trends for Razavi Khorasan province, Iran.

Methods:

In order to determine the baseline number of deaths, we used univariate time series analyses for monthly data from the monthly vital statistics reports (From April 2015 to March 2022). For excess mortalities, these baselines were subtracted from reported deaths with a 95% prediction interval. To compare time and causes, a P-score was calculated.

Results:

From March 2020 to March 2022, there were 61949 registered deaths, and the estimated deaths with a 95% confidence interval (CI) were 43246.16 (35718.28, 50774.05). So, in 2020-2021 and 2021-2022, the death counts were 35.15% and 51.33% higher than projected. A total of 18666 cardiovascular diseases were reported and a total of 15704.46 (12006.95, 19401.96) was estimated. The P-score for this duration was 14.49% and 23.23% higher than expected. Infectious and parasitic diseases plus COVID-19 were 16633 and estimated to be 1044.87 (456.77, 1632.96). A total of 4420 diseases of the respiratory system were reported, and 4564.94 deaths were predicted (2277.43, 6852.43). In the first year of the pandemic, the P-score dropped to -35.28% and in the second year, it jumped sharply to 22.38%.

Conclusions:

Excess mortality, along with cause-specific mortality, can be helpful for monitoring trends and developing public health policies at the local, national, and international levels.
Prevalence of Hypocortisolemia in Patients with Sepsis or Septic Shock (The HIS Study) Presenting to the Emergency Department
Authors: Pienyu Peleneilhou , Hazra Darpanarayan , Chandy Gina M. , Sharma Parth , Jeeyavudeen Mohammad S. , Abhilash Kundavaram P. P.
Published: October 2023

Background:

Cortisol response to stressors (hypothalamic–pituitary–adrenal axis, autonomic nervous system, and immune system) plays a vital role in maintaining stable metabolic homeostasis. This study was done to assess the prevalence of hypocortisolemia in patients presenting to ED with sepsis and/or septic shock.

Methods:

This prospective observational study was done from July 2020 to April 2021. Serum cortisol levels were measured in patients with sepsis and septic shock, and their clinical and laboratory profile was categorized, coded, and analyzed.

Results:

Ninety-eight patients were included, of which serum Cortisol <10 mg/dl was noted in 7 (7.2%) patients. The cohort’s mean age was 52.9 (SD: 15.3) years with a male predominance (n-61; 62.2%). Most common presenting complaint was fever (n-52; 53.1%), followed by abdominal pain (n-24; 24.5%), and breathing difficulty (n-14; 14.3%). Systolic blood pressure <90 mmHg and tachycardia were seen in 63 patients (64.3%). Assessment of diet and native medication use did not demonstrate a predisposition to hypocortisolemia. The median (IQR) arterial lactate values were lower in the hypocortisolemic group: 2.2 (1.2–2.5) as compared to the non-hypocortisolemic group: 3.7 (2.2–8.0). Patients with septic shock without hypocortisolemia were noted to have a higher mean lactate level (2.6 ± 1.3 Vs 5.4 ± 3.9) and lower platelet counts compared to those with low cortisol levels. Patients with normal cortisol levels (n-38; 38.8%) still had low ACTH values.

Conclusion:

The prevalence of hypocortisolemia was lower when compared to other Indian studies. Diet and native medication use do not predispose Indians to hypocortisolemia.
Posterior to the ridge laser in zone 2 stage 3 retinopathy of prematurity with plus disease: Efficacy and safety
Authors: Sanghi Gaurav , Gupta Rajeev , Narula Sunny
Published: October 2023

Purpose:

This study aimed to ascertain the efficacy and safety of an additional posterior to the ridge laser for treatable zone 2 stage 3 retinopathy of prematurity (ROP).

Methods:

This study was a retrospective chart review of infants undergoing laser treatment for ROP at a single center from March 2014 to March 2022. The chart review specifically searched for infants treated for zone 2 stage 3 ROP with plus disease, where additional posterior to the ridge laser was performed.

Results:

Seventy-eight eyes of 45 infants met the inclusion criterion. The mean birth weight and gestational age were 1166.09 ± 329.66 gm and 29 ± 2 weeks, respectively. Group 1 comprised 52 eyes treated for high-risk prethreshold stage 3 ROP, while group 2 comprised 26 eyes treated for threshold ROP. 532-nm frequency-doubled Nd:YAG laser (Nidek, Japan) was used in all eyes. Apart from the standard laser to the avascular retina, an additional three rows of laser were applied posterior to the ridge in all eyes during the primary laser sitting (except in two eyes where it was performed as a rescue treatment 2 weeks after the first sitting). No complications were observed during or immediately after the laser procedure. A favorable outcome was achieved in 98.07% of eyes with prethreshold ROP and 76.92% of eyes with threshold ROP. Overall, a favorable outcome was achieved in 71 (91.02%) of the 78 eyes.

Conclusion:

Posterior to the ridge laser performed in the primary sitting along with the standard laser for treatable stage 3 ROP in zone 2 is safe and effective. Further prospective studies are needed to study this underutilized approach.
Color perception on Ishihara plates with red lenses in subjects with low vision due to retinal diseases
Authors: Sodhi Punita K , Gautam Akanksha , Rao Kavya C , TR Archana , Sharma Nandini , Marimuthu Yamini
Published: October 2023

Purpose:

This study aimed to evaluate color perception (CP) changes on Ishihara plates following red-tinted contact lenses in subjects with low vision (LV) from retinal diseases.

Methods:

A cross-sectional observational study without control involved 84 subjects, aged 20–70 years, having LV from retinal diseases to examine CP changes following wearing red-tinted contact lenses. The subjects viewed Ishihara plates, with each eye separately, before and after wearing red lenses in two categories: “plates 1–21” and “plates 22–25”. Change in CP with the use of a red lens was the primary outcome measure.

Results:

There was a significant increase in the number of plates read in both categories, that is, plates 1–21 (P = 0.002) and plates 22–25 (P = 0.032), the latter being used to diagnose the red-green defects. Although 70 eyes could read both digits on plates 22–25 and appeared to have normal color vision (CV) at baseline, this number rose to 99 eyes following the use of red-tinted lenses. There was a significant change in the type of CP (red defect/green defect/normal/undefined defect) (P = 0.022) with the application of a red-tinted lens.

Conclusions:

The use of red-tinted lenses caused a significant increase in the number of plates read, increased the number of subjects who appeared normal on plates 22–25, and significantly changed CP of LV subjects. These lenses can be a valuable aid for LV subjects. Although Ishihara plates can diagnose only red-green defects, further studies on CV testing techniques that detect both red-green and blue-yellow CV defects are recommended.
Demographic and microbiological profile of corneal ulcer patients presenting at a tertiary healthcare center of Eastern India during the COVID era: A hospital-based cross-sectional study
Authors: Aftab Naila , Raj Amit , Chandra Bhawesh , Pati Binod Kumar , Singh Prabhakar
Published: October 2023

Purpose:

To determine the demographic and microbiological profile involved in the causation of corneal ulcers in Eastern India during the COVID era.

Method:

Patients presenting with corneal ulcers fulfilling the inclusion and exclusion criteria were taken as the case. The study duration was from January 2021 to December 2021. Socio-demographic details and information about risk factors were noted. A detailed corneal examination followed by corneal scraping was performed for microbiological evaluation.

Results:

In 1 year, 99 infective corneal ulcer patients were evaluated. Farmers (24.2%) were found to be maximally affected by corneal ulcers. The peak in cases was recorded from October to December (38.4%). Ocular trauma was the commonest risk factor (42.4%). The majority (80.8%) of patients were already on some topical antimicrobials. 22.2% of samples showed fungal filaments on KOH mount; 54.5% of these cases turned out to be culture-positive. 17.56% of KOH-negative samples turned out to be culture-positive (fungal). Overall, the culture positivity rate was 28.28% out of which fungal isolates were 89.28% and bacterial isolates were 10.72%. Fusarium species were identified as the most common organism contributing 42.85%, followed by Aspergillus fumigatus (14.28%). 10.72% of cases were culture positive for Pseudomonas aeuroginosa.

Conclusion:

Trauma with the organic matter was the predominant cause of fungal keratitis. In this study, fungal keratitis was found to be more common. Fusarium was the most common isolate.
Surgical outcomes in aggressive retinopathy of prematurity (AROP)-related retinal detachments
Authors: Sen Parveen , Bhende Pramod , Maitra Puja
Published: October 2023

Introduction:

Aggressive retinopathy of prematurity (AROP) is a severe and progressive variant of retinopathy of prematurity (ROP) rapidly forming fibrous tissue extending from the disc toward the posterior lens surface progressing to Stage 5 disease without traversing the classical course that includes Stages 1 to 3. Since AROP behaves differently from type 1 ROP, this study was undertaken to evaluate the surgical outcome of AROP-related detachments.

Methods:

Retrospective analysis of data from electronic medical records of babies diagnosed with AROP-related detachments who underwent micro-incision vitrectomy surgery (MIVS) was included. The demographic data, details of primary intervention (laser and/or intravitreal bevacizumab), and surgery were noted. In a subset of patients, surgical intervention was planned early at the onset of fibrovascular tissue.

Results:

43 eyes of 26 babies with median birth weight 1175 g and median gestational age of 29 weeks were analyzed. 42/43 eyes underwent primary intervention in form of laser and/or anti-VEGF injection before surgery. 41.8%, 25.5%, and 32.5% eyes progressed to stages 4A, 4B, and 5, respectively, requiring surgical intervention. 66% eyes underwent lensectomy and vitrectomy (LV), and 44% eyes underwent lens sparring vitrectomy (LSV). 58% eyes had attached macula. 44% eyes that had a relatively less vascular diseases had better anatomical outcome (P = 0.019). At final follow-up, 53.4% eyes followed or at least had light fixation, and 77.7% eyes undergoing LSV fixated and/or followed light compared to 33% for LV (P = 0.04).

Conclusion:

Challenges in AROP include rapid progression to advanced stages of ROP requiring close monitoring and multiple interventions. Surgeries for AROP have a favorable anatomical and functional outcome in 58% and 53%, respectively. Eyes undergoing lens sparing vitrectomy had better visual outcomes.
Understanding pseudopapilledema on spectral domain optical coherence tomography
Authors: Bassi Shikha Talwar , Pamu Ramesh , Varghese Anjaly
Published: October 2023

Purpose:

Optic nerve head drusen (ONHD), peripapillary hyperreflective ovoid mass-like structures (PHOMS), and horizontal hyperreflective lines (HHL) are commonly seen in eyes with pseudopapilledema on enhanced depth imaging (EDI) spectral domain optical coherence tomography (SDOCT). The objective of this study is to assess the frequency of ONHD, PHOMS, and HHL on spectral domain OCT in the eyes diagnosed to have pseudopapilledema.

Methods:

A retrospective case–control study included patients diagnosed as pseudopapilledema and had EDI SD OCT imaging of the optic nerve head (n = 48 eyes) and controls (n = 20 eyes). OCT scans through the optic nerve head were studied to diagnose ONHD, HHL, and PHOMS. One proportion z test was used to find the difference in proportions.

Results:

Forty eight eyes of 27 subjects were studied. ONHD as described by the optic disc drusen Studies consortium was noted in 19 eyes (39.48%), P value-0.032, PHOMS in 31 eyes (64.6%), P value 0.043, HL in 19 eyes (39.48%), P value 0.032, and none of the normals had ONHD, PHOMS, and HHL.

Conclusions:

PHOMS are more frequently seen than ONHD and HHL in eyes with pseudopapilledema.
Surgical and visual outcomes after vitreoretinal surgery for complex retinal capillary hemangioblastoma
Authors: Raval Vishal R , Agarwal Aniruddha , Tyagi Mudit
Published: October 2023

Purpose:

We evaluated the anatomical and functional outcomes after vitreoretinal surgery for complex retinal capillary hemangioblastoma (RCH).

Methods:

This was a retrospective case series of 15 patients (16 eyes) with tractional or combined retinal detachment (RD) managed with pars plana vitrectomy and tumor endoresection (ER) with/without feeder vessel ligation.

Results:

The mean age at the time of surgery was 30 years (range, 14–46 years). The most common tumor locations were inferotemporal (six eyes) and temporal (six eyes) quadrants. Indications for surgery included exudative RD with fibrovascular proliferation (eight eyes), combined RD (five eyes), vitreous hemorrhage (four eyes), and rhegmatogenous RD (two eyes). Tumor destruction was performed with laser and/or cryotherapy in nine eyes (57%) and ER in seven eyes (43%). Feeder vessel was ligated and cauterized in 10 (63%) and six eyes (37%), respectively. Anatomical success after initial surgery was 50% (eight eyes), which improved to 88% (14 eyes) after they underwent a repeat procedure for recurrent RD (eight eyes). At the last visit, visual acuity improved in seven eyes (44%), was stable in four eyes (25%), and worsened in five eyes (31%) with a mean follow-up of 29 months (6–79 months). Comparison between the ER group and the laser/cryotherapy group revealed no significant difference in final retinal reattachment rate (89% vs. 86%, P > 0.05), with better visual outcomes in laser/cryotherapy group (57% vs. 78%, P < 0.05).

Conclusion:

Pars plana vitrectomy with/without tumor endoresection can be a safe and effective treatment option for complex RCHs, achieving good tumor control and anatomical success with limited functional success.
Usefulness of Children’s Hospital of Philadelphia ROP (CHOP ROP) model in the prediction of type 1 ROP
Authors: Jain Barkha , Sethi Neha K , Sethi Amanpreet , Arora Rhythm , Gupta Twinkle , Kaur Harnoor
Published: October 2023

Purpose:

Children’s Hospital of Philadelphia retinopathy of prematurity (CHOP ROP) model can be used to predict ROP, a leading cause of childhood blindness, using risk factors such as postnatal weight gain, birth weight (BW), and gestation age (GA). The purpose of this study was to determine the usefulness of the CHOP ROP for the prediction of treatable ROP.

Methods:

This was a prospective observational study. Babies <34 weeks of GA, BW <2000 grams, and GA 34–36 weeks with risk factors such as respiratory distress syndrome (RDS) were included; ROP screening, follow-up, and treatment were performed based on national guidelines. The average daily postnatal weight gain was measured, and the CHOP nomogram was plotted. Babies were categorized as high risk or low risk based on the “CHOP” alarm. The sensitivity and specificity of the CHOP ROP for the detection of treatable ROP were determined. In case of poor sensitivity, a new cutoff alarm level was planned using logistic regression analysis.

Results:

Of 62 screened infants, 23 infants did not fulfill the criteria of the CHOP algorithm and were excluded. Thus, in the study on 39 infants, the predictive model with an alarm level of 0.014 had 100% specificity and 20% sensitivity. With the “new” alarm level (cutoff) of 0.0003, the CHOP nomogram could detect all the infants who developed treatable ROP, that is, sensitivity increased to 100% but specificity decreased to 10.5%.

Conclusion:

The CHOP ROP model with a cutoff point (0.014) performed poorly in predicting severe ROP in the study. Thus, there is a need to develop inclusive and more sensitive tailor-made algorithms.
Surgical management of glaucoma in microspherophakia using quadruple procedure
Authors: Rajendrababu Sharmila R , Ramesh Sujitha , Kannan Naresh B , Rao Mythri K
Published: October 2023

Background:

Microspherophakia is a rare developmental lens anomaly with increased anteroposterior and reduced equatorial diameter. It presents with refractive myopia, shallow anterior chamber, and angle closure glaucoma. It is associated with subluxated or dislocated lens, progressive myopia, defective accommodation, and glaucoma. Glaucoma is the most common vision-threatening complication and mostly requires surgical management that includes trabeculectomy, lensectomy, and drainage implant. A staged or combined procedure can be performed. The purpose of this video is to highlight the advantages of combining parsplana vitrectomy (PPV) with parsplana lensectomy (PPL), scleral fixated intraocular lens (SFIOL), and Aurolab aqueous drainage implant (AADI) in a young patient with advanced glaucoma and gross subluxation. Drainage implants are preferred over filtering surgeries in eyes undergoing vitreoretinal procedures due to the risk of bleb fibrosis and hypotony seen in the latter. The combined procedures should be tailored according to the lens status and severity of glaucoma in each patient.

Purpose:

The purpose of this video is to illustrate a combined quadruple procedure (PPL, PPV, SFIOL, and AADI) in microspherophakic patients with unstable glaucoma and video-based skill transfer to a novice surgeon.

Synopsis:

This video illustrates quadruple surgery in a microspherophakic patient with secondary angle closure glaucoma. The authors also emphasize the advantages of a combined quadruple procedure over staged procedure or combined PPL with filtering procedure.

Highlights:

Quadruple procedure can be performed in young microspherophakic patients with advanced glaucoma or at risk of progression and losing central vision along with gross subluxation of lens. It eliminates the need for multiple procedures, the risk of hypotony, and bleb-related complications.

Video link:
https://youtu.be/KdFjb7acXCI
The impact after 20 years of an early detection program for severe retinopathy of prematurity in a Latin American city
Authors: Zuluaga-Botero Claudia , Cantor Erika , Bonilla Francisco , Robayo-Velásquez Juan F , Martínez-Blanco Alexander M
Published: October 2023

Purpose:

To evaluate the effects of long-standing early detection program in the incidence and trends of severe retinopathy of prematurity (ROP) in Cali, Colombia.

Methods:

This was a retrospective cohort study of infants included in an ROP prevention, early detection, and prompt treatment program, from January 01, 2002, to December 31, 2021 (20 years). Infants with gestational age (GA) <37 weeks or birth weight (BW) <2000 g and those with known ROP risk factors were screened. The incidence of severe ROP was calculated, and the average annual percent change (AAPC) was estimated through a joinpoint model.

Results:

16,580 infants were screened, with an average GA and BW of 31.4 ± 2.8 weeks and 1526.5 ± 56.7 g, respectively. The incidence of severe ROP was 2.69% (446 cases, 95% confidence interval [95%CI]: 2.45%; 2.95%), with an average annual decrease of − 14% (AAPC, 95%CI: −16.3%; −11.6%) from 13.6% in 2002 to 0.7% in 2021. In infants with GA <32 weeks, the incidence was 5.21%. A significant reduction in the risk of ROP was observed with increasing GA and BW (P < 0.05). Among the cases with severe ROP, 6.5% (29/446) had a GA ≥32 weeks with a maximum of 37 weeks; only 0.4% (2/446) of the detected infants had a BW >2000 g.

Conclusion:

Awareness and screening as part of the early detection program to prevent ROP has shown a significant decline in the incidence of severe ROP over time. Screening infants with GA <32 weeks or BW <2000 g and preterm infants (<37 weeks) with risk factors may be a feasible decision for resource optimization.
Comparison of intraoperative blood pressure values measured by noninvasive versus invasive methods during normotension, hypertension, and hypotension
Authors: Irimpan Joel , Kesavan Rajesh , Rajan Sunil , Kumar Lakshmi
Published: October 2023

Background and Aims:

Monitoring of intraoperative blood pressure (BP) is essential. We aimed to compare BP values simultaneously recorded by invasive and noninvasive methods under general anesthesia (GA) during normotension, hypertension, and hypotension. Mean arterial pressure (MAP) values calculated by the automated technique were also compared to the values obtained using predefined formula.

Material and Methods:

An observational, prospective study was conducted in 250 adult patients undergoing elective surgeries under GA. Before induction, noninvasive blood pressure (NIBP) was measured in the arm in a supine position using an automated oscillometer. Radial artery in the opposite arm was cannulated. NIBP and arterial BP (ABP) were recorded simultaneously during normotension, hypotension, and hypertension.

Results:

During normotension and hypertension, systolic BP (SBP) measured by NIBP and ABP were comparable. Diastolic BP (DBP) and MAP during normotension were significantly higher with NIBP (73.65 ± 7.73 vs. 65.69 ± 8.39 and 87.79 ± 8.43 vs. 84.24 ± 8.82, respectively). During hypertension, DBP and MAP were significantly higher with NIBP (90.44 ± 11.61 vs. 78.59 ± 11.09 and 111.67 ± 10.43 vs. 105.63 ± 11.06, respectively). During hypotension, SBP was significantly higher in ABP (91.14 ± 6.90 vs. 86.24 ± 6.06), and DBP and MAP were comparable. Comparison of MAP measured by ABP and NIBP techniques with the MAP calculated using predefined formula in normotension showed significantly higher values with the automated technique.

Conclusions:

During normotension and hypertension, DBP and MAP showed significantly higher values with the NIBP technique compared to ABP, with comparable SBP values. During hypotension, SBP showed significantly higher values with the ABP technique, with comparable DBP and MAP. MAP obtained using predefined formula and automated method in normotension was significantly higher with the automated technique.
Effect of operation table height on ease of mask ventilation, laryngeal view, and endotracheal intubation success
Authors: Jain Mamta , Tantia Kunika , Johar Sanjay , Singh Anish Kumar , Bansal Teena , Sharma Jyoti
Published: October 2023

Background and Aims:

Optimal patient positioning and operating table height are essential for an ergonomic posture of an anesthesiologist in which there is minimal or no strain on thewrist during mask ventilation. It also avoids flexion of the neck, lower back, and knee bending at the time of laryngoscopy and intubation.

Material and Methods:

One hundred eighty patients were randomly allocated to three groups based on different table heights. The height of the table is kept at the mid-sternum level of an anesthesiologist in group 1, at the xiphoid process in group 2, and at the level of umbilicus in group 3. Laryngoscopic view with or without postural changes (exertion at wrist joint, flexion of the neck, lower back, or knee bending) was graded as per Cormack Lehane’s (CL) grading. The degree of discomfort experienced by the anesthesiologist during mask ventilation or tracheal intubation was graded subjectively (1 = no discomfort, 2 = mild discomfort, 3 = moderate discomfort, and 4 = severe discomfort) at different table heights. Postural changes required to obtain the best glottic view and quality of endotracheal (ET) intubation (intubation time and attempts required) were also noted. For analysis, quantitative variables were expressed as mean ± SD and compared using unpaired t or analysis of variance test. Qualitative variables were expressed as frequencies/percentages and compared using the Chi-square test. Results with P value <0.05 were considered significant statistically.

Results:

Moderate discomfort (strain at wrist joint) during bag–mask ventilation was experienced by the anesthesiologist in a maximum number of patients in group 1 (81.7%). Significant improvement was seen in CL grade after the use of postural modifications in groups 1 and 2 (P value ≤0.05). Greater postural modifications were required during ET intubation at lower table heights (group 3).

Conclusions:

It is advisable to adopt higher table positioning in relation to anesthesiologist performing the laryngoscopy for smooth and single-attempt ET intubation since the best laryngoscopic view and intubation with minimal postural modifications was seen at higher table heights (at the mid-sternum level of an anesthesiologist).
Ureteral stents: A brief narrative review of the different polymeric types, their characteristics, and their connection to stent-related symptoms
Authors: Bellos Themistoklis Ch. , Katsimperis Stamatios N. , Tzelves Lazaros I. , Kostakopoulos Nikolaos Athanasios , Markopoulos Titos P. , Mitsogiannis Iraklis C. , Varkarakis Ioannis M. , Papatsoris Athanasios G. , Deliveliotis Charalampos
Published: October 2023

Background:

In routine urological practice, pigtails are frequently utilized to relieve blockage. Early signs of pigtail problems include pain, lower urinary tract symptoms, pain, hematuria (54%) and fever. Seventy percent of patients experience irritable voiding symptoms, and 80% of patients or even more report pain interfering with everyday activities.

Methods:

This article’s goal is to evaluate the various polymeric stents that are currently on the market. In addition, a review of their fundamental bioqualities is conducted, and a connection between their physical attributes (length, size, and composition) and stent-related issues is looked into. For this review, extensive Medline, PubMed, and literature research from 1987 to January 2023 was conducted. Lower urinary tract complaints, ureteral stents, “pigtail,” “materials,” “characteristics,” or “properties” were the search terms employed.

Results:

The reviews and publications that are now accessible linking certain materials to stent-related symptoms offer contradictory conclusions, and the majority of research do not specify the precise properties of the materials utilized. The results of the studies on the relationship between stents length and diameter and symptoms connected to stents are likewise inconclusive, despite the fact that there are several studies on this topic in the literature.

Conclusion:

Numerous studies imply a connection between the various types and properties of the utilized stents and stent-related complaints. However, the available data did not fully support this claim, necessitating additional research.
Assessment of Psychological Well-Being among Relatives of Patients Diagnosed with Psychotic Disorders in Neuro-Psychiatric Hospitals in South-West Nigeria
Authors: Titilope Maitanmi Bukola , Olaniyi Aina Joseph , Olatade Maitanmi Julius , Ajoke Anokwuru Rafiat , Oluwatoyin Oyedele Titus , Olufemi Ogungbesan Joshua , Abiodun–Ojo Olubukola Esther
Published: October 2023

Background: Psychotic disorder contributes to the mental health global burden. Having a family member suffering from the illness may  result in a caregiver's psychological well-being depletion, increased burden of care and low quality of life. The study assessed the  psychological well-being and the militating stressors against the relatives of patients diagnosed with psychotic disorder psychological  well-being in Neuro–a psychiatric hospital in South-west Nigeria.

Method: The research used a qualitative design to assess the  psychological well-being of relatives, militating stressors against their psychological well-being and coping strategies adopted. Samples  were obtained by purposive sampling technique to select forty-four (44) participants and one-on-one interviews using semi–structured  interviews done. The data were collected by interview and using a recorder and the same was transcribed verbatim and analysed thematically.

Result: The results generated were categorized into themes and subthemes which included: lack of autonomy, acceptance  of the situation, insecure relationships with families and friends, poor environmental mastery, and impact on physical and psychological  well-being while the sub-themes included: uneasy decision, maladaptive coping, stigmatization, unsupportive family and friends, financial  burden, and reduced quality of life.

Conclusion: The study suggests that nurses and other health professionals aid relatives in  improving their coping skills, sensitization of the populace on mental disorders and provision of adequate information in the form of  educational intervention may enhance their psychological well-being.
Sleep Insufficiency among Adolescents in Africa: A Narrative Review
Authors: Bello Bashir , Useh Ushotanefe , Abdurrahaman Mamuda Alhaji
Published: October 2023

Background: Sleep insufficiency (SI) among adolescents is a global public health concern, but its prevalence and impact on African  adolescents remain poorly understood. Extensive research has been conducted on SI in developed countries, but there is a lack of  knowledge about its occurrence and consequences in Africa.

 Objective: This study aims to thoroughly review existing literature on sleep  insufficiency among African adolescents to determine the extent of SI, its health implications, and its economic burden.

Methods: A  systematic search was performed in PubMed, EBSCOhost, Web of Science, Scopus, and Sabinet (African Journals) from the inception of  these databases until February 14, 2023. The search terms used included "insufficient sleep," "sleep loss," "sleep disorders,"  "adolescents," "youth" aged 12-17 years, and "Africa." Only five of the 15 eligible full-text studies identified met the inclusion criteria and  were included in this review.

Results: The available studies on SI among African adolescents were limited, but all the included studies  reported a high prevalence of SI in this population. Factors associated with SI in Africa included nighttime use of electronic gadgets, co-sleeping with siblings, and nightmares. No intervention or treatment studies for SI among African adolescents were found, and none of the studies explored the  health consequences or estimated the economic burden of this condition.

Conclusion: There needs to be more research on sleep insufficiency among African adolescents, with limited information regarding its  prevalence, health implications, and economic burden. Further studies are necessary to address this knowledge gap, which can  contribute to policymaking and developing accessible and cost-effective interventions to manage sleep insufficiency in this population.
Factors Influencing Cost Performance of Construction Projects in Kaduna State
Authors: Buba G.S.
Published: October 2023

The prime objective of every client is to accomplish the project within the agreed budget and time. The construction industry has been  described as one of the most fragmented, multifaceted, time and material-driven industry. The industry is always faced with challenges  such as low quality, low productivity, delay, cost overrun, etc. The issue of cost does have obvious implications for the key stakeholders in  particular, and the industry in general. Therefore, this study aimed at exploring those factors that influence cost performance of the  construction projects in Kaduna State with a view of establishing the bases for professionals to note when carrying out cost management  of any project. The objective of this study is to establish the main factors influencing cost in the Kaduna state construction projects. This  study was carried out in Kaduna state, Nigeria. The Methodology used was quantitative research approach. With the aid of a  questionnaire survey, data was collected using Simple random sampling. The target population of this study was 827 while the sample  size used was 270. 198 questionnaires were filled and returned. Exploratory factor analysis was used to analyse the data so as to identify factors capable of being understood. Out of which seven underlying factors were identified. The seven-component solution explained a  total of 75.782% of the variance explained with component 1 contributing 19.250%, component 2 contributing 14.585%, component 3  contributing 11.737%, component 4 contributing 10.744%, component 5 contributing 7.813%, component 6 contributing 6.872% and  component 7 contributing 4.781% establishing the factors influencing cost performance in the Kaduna state construction projects. They  are: Project Management Factor, Expertise and Market Forces Factors, Contract Management Factors, Contractual and Socioeconomic  Factors, Government Policies and External Factors, Procedural and Standards factor and, Experience and Service Cost Factor. Hence,  concluded that much focus should be placed on these factors in order to reduce the cost of construction project, enhance construction  cost performance for the client and generate confidence within the construction industry for professionals. The study recommended that  the clients, consultants and contractors should undertake the execution of construction works with deliberate and due diligence towards minimizing these factors influence on the cost of construction project as identified from the study.
Antimicrobial Resistance Profile of Escherichia coli and Salmonella Isolated from Meat Sold in Sokoto Central Market, Sokoto State
Authors: Aliyu R.M. , Abubakar M.B.
Published: October 2023

This study was designed to isolate and identify Escherichia coli and Salmonella spp. from raw-meat samples, on retail in the Sokoto central market and test their susceptibility to commonly prescribed antibiotics. Meat samples (n=40) were randomly collected from selected retail spots within the Sokoto metropolis, pre-enriched in buffered peptone water and incubated at 37°C for 12 hours. Pre- enriched samples were streaked on MacConkey agar and incubated at 37°C for 24 hours. The isolates were subjected to a series of biochemical tests for characterization and subsequent antimicrobial sensitivity testing using the disc diffusion method. Of the 40 samples collected, 7 were contaminated with E. coli and Salmonella spp. Antibiotic sensitivity testing showed that E. coli and Salmonella spp isolates were both resistant to chloramphenicol (10µg), ampicillin (30µg), amoxicillin (30µg), cefuroxime (30µg) and norfloxacin (10µg) In conclusion, this study showed that E. coli and salmonella spp. isolates from raw beef sold in Sokoto open market were multiple drug resistant strains which underscores a public health concern.
Profit Analysis of Small-Scale Poultry Layers in Iwo Agricultural Development Programme (ADP) Zone of Osun State
Authors: Akintunde O.K. , Adedire A.O. , Coster A.S. , Osunkeye O.J.
Published: October 2023

This study focused on the profit analysis of small-scale poultry layers in Iwo ADP Zone of Osun State. Data were collected from the poultry farmers using a well-structured questionnaire and multi-stage sampling procedure. A total sample size of one hundred and five (105) poultry farmers was selected. Data were analyzed using descriptive statistics budgetary analysis and inferential statistical tools (OLS). Results of the study revealed that majority (80%) of the farmers were below 50 years and the farmers’ mean age was 49.5±7.7 years. The majority (95%) of the farmers had primary education and above. The mean year of experience was 11.0±3.4 years. The mean birds reared and profit was 405 birds and N84, 849.54 respectively. Return on investment during the period was N1.04 establishing positive returns. Household size, years of poultry farming experience and stock size were the factors significantly influencing the profit positively. Therefore, it is suggested that poultry farmers in the study area should try to increase their pen size, explore the use of family labour and endeavour to learn new methods of poultry management from farmers with more years of poultry-keeping experience to increase their level of profit.
Gas Chromatography-Mass Spectroscopy(GC-MS) of Chloroform Extract of Ficus exasperata Vahl
Authors: Mohammed R S , Yagana B A , Kntapo F M , Saidu G , Abah J O , Idris A
Published: October 2023

Gas Chromatography-Mass Spectrometry (GCMS) analysis of chloroform leaves extract of Ficus exasperate Vahl was performed to identify the composition and percentage abundance of the various phytochemical constituents of Ficus exasperate Vahl. The extract was obtained by fractionating methanol crude leave extract of Ficus exasperate Vahl with in order of increasing polarity, n-Hexane then chloroform. GC-MS analysis was carried out on a GC system comprising a Gas Chromatograph interfaced to a Mass Spectrometer (GC-MS) instrument. The components were compared with the database of spectrum of known components stored in the gas chromatography-mass spectrometry library. Gas Chromatography-Mass Spectrometry analysis of the chloroform leave extract of Ficus exasperate revealed the presence of acyclic olefin which is used for tanning oils and in synthetic fatty acids, Isopryl myristate used in cosmetics, Dibutyl phthalate which is used in cosmetics, textile, safety glass additive, oleic acid used in pharmaceuticals, Cyclopropanecarboxylic acid, 3-(2,2-dichlor used in agrochemicals and pharmaceuticals. The presence of these compounds justifies the use of some parts of the plant for various elements in folklore and can be advised as a plant of phytopharmaceutical and industrial importance.
Anti-Hyperglycemic and Antioxidant Potentials of Some Bioactive Compounds Identified From The Methanolic Kernel Extract of Anacadium ocidentale in vitro and in silico Investigations
Authors: Ahmed S A , Ajiboye A T , Ibrahim Y A , Olagunju A T , Salau S , Adetunji O
Published: October 2023

The phytochemical components of roasted kernel of cashew nut (Anacadium ocidentale), its antioxidant and anti-hyperglycemic potentials were investigated via in vitro and in silico.  The roasted kernel of cashew nut was extracted in 95 % methanol.  Using boron trifloride (10 % in 1-butanol), the extract was derivatized and the derivatized sample was analyzed using a Gas Chromatographic–Mass Spectrometry (GC-MS) method to establish its chemical constituents. Antioxidant potential was evaluated through 2, 2-diphenyl-1-picrylhydrazyl (DPPH•) and 2,2′-azino-bis-(3-ethyl benzothiazoline-6-sulphonic acid)  (ABTS•+)  radical scavenging assays. The anti-hyperglycemic potential of the crude methanol extract was investigated through α-glucosidase assay. The results of phytochemical screening revealed the presence of phytochemicals such as phenols, glycosides, alkaloids, steroids, carbohydrate, flavonoids and terpenoids. Total numbers of 20 phytochemicals belonging to different classes of natural products were identified by GC-MS analysis.  Carbonic acid, dodecyl vinyl ester (45.9 %) was found to be the major compound. Other compounds like N- serylserine, D- fructose, 3-0-methyl, β- Amyrone, β- Amyrin, Lupeol and 9- octadecenoic acid were also identified. The methanol extract of roasted cashew kernel showed highest DPPH scavenging activity (IC50 10 ± 0.001 µg/mL) which is statistically similar to positive controls, vitamin C and rutin (IC50 = 4 ± 0.001 and 1 ± 0.0001 µg/mL) and also exhibited moderate ABTS scavenging activity (IC50 = 14 ± 0.001 µg/mL) which is statistically significant as compared to positive controls, vitamin C (IC50 = 13 ± 0.01 µg/mL) and rutin (IC50 = 16 ± 0.001 µg/mL) respectively.  The result of enzyme inhibition assay showed that the extract possesses highest anti-hyperglycemic potential against α-glucosidase with IC50 value (0.00024 ± 0.00002 µg/mL) compared to standard drug acarbose (IC50 = 0.417 ±0.021 µg/mL). The in silico techniques comprising the molecular docking, bioactivity and toxicity studies provides insight into the inhibitory properties, structure-activity-relationship predictions and drug-likeliness activities of the identified compounds. The research reveals the bioactive components present in the roasted kernel of cashew nut that can be utilized for its antioxidant and anti-hyperglycemic properties.  Hence consumption of roasted cashew kernel could be beneficial for the treatment of diabetes mellitus and prevention of oxidative stress-related degenerative disorders
Capacities and irreversibility of the vapour compression refrigeration system’s components using aluminium oxide (Al2O3) based nanolubricants
Authors: Ogbonnaya M. , Ajayi O. O. , Waheed M.A.
Published: October 2023

Hydrochlorofluorocarbon and chlorofluorocarbon refrigerants commonly used in vapour compression refrigeration system (VCRS) have been phased out due to their negative impact on the ecosystem. R134a and R600a refrigerants were considered as their replacement, but they possess low thermal properties, thereby affecting the performance of the VCRS. In this study, the effect of varying aluminium oxide (Al2O3) nanoparticle size (10 nm, 20 – 30 nm and 80nm) and volume concentration (1%, 3%, 5% 10% and 20%) on the capacity and exergy efficiency of each component of VCRS for the optimisation of the VCRS performance and reduction of energy consumption was analysed using R134a and R600a refrigerants. The nanolubricant were prepared using the two-step method. The VCRS showed no significant deterioration in the performance of its components as confirmed for over 24 hours when nanorefrigerant was used. The compressor capacity of nanorefrigerant was lower than that of pure refrigerants while the addition of nanoparticle enhanced the refrigeration effect. The exergy efficiency of the vapour compression system improved with the addition of nanoparticles into the system, the exergy destruction caused by friction in the compressor significantly reduced, thereby reducing the energy consumed by the system.
Performance analysis of a permanent magnet synchronous motor with dual stator windings
Authors: Tola O. J. , Obe E. S. , Anih L. U.
Published: October 2023

This paper presents the modelling and performance analysis of a line-start three-phase interior permanent magnet synchronous motor (IPMSM) with dual stator windings. The machine has two sets of windings, main and auxiliary windings. The main winding is connected to the supply while the auxiliary is connected to a balanced capacitor. The dynamic model equations are derived in the d-q rotor reference frame using the concept of winding function theory. The machine input impedance was construed from the steady-state equations, where the effects of capacitance on the performance of the motor were studied. An improved torque was obtained when a suitable capacitance was connected to the auxiliary winding. A point of good performance was established by enhancing its direct axis reactance and the quadrature axis reactance which depend on the size of the capacitor. It is shown that thenew configuration has better performance characteristics when compared with those of the traditional configuration in terms of output power, torque density and efficiency.
Maximising efficient water capacity through reservoir configuration with a case study for Malang City of Indonesia
Authors: Samudro G. , Samudro H. , Mangkoedihardjo S.
Published: October 2023

All forms of water supply systems had unique characteristics of idle capacity. However, achieving a sustainable water supply over the long term could not eliminate idle capacity. This paper discussed methods for providing efficient capacity without compromising long-term water requirements. The objective of efficient capacity was to reduce idle water capacity and water-carrying infrastructure. This study method reviews previous research results with an in-depth case of a piped water supply system in an urban area. The assessment method referred to the pattern of water demand by consumers. Fluctuations in water demand determined the dimensions of all water supply system components. The results of this study showed that water distribution determines the minimum idle capacity, which directs the need for priority areas for efficient capacity and opens reservoir placement options. Under these priority areas, a decentralised reservoir position resulted in an efficient system dimension. The closer the reservoir was to the consumer, the smaller the idle capacity, which was the contribution of the onsite reservoir. The critical implementation was based on the flexibility of the phasing of water supply and infrastructure. The flexibility addressed the use of flow rates for a certain period, diversification of water sources, and system configuration that determines the dimensions of the infrastructure and maximising utilisation.
Optimal capacitor planning for power factor improvement using hybrid particle swarm and harmony search optimization
Authors: Ibrahim A. H. , Ashigwuike E. C. , Oluyombo W. , Sadiq A. A.
Published: October 2023

Industrial loads reduce the Power Factor (PF) of supply systems, causing increases in power losses, damaging equipment and higher utility bills. Optimization techniques are used in planning reactive sources to improve PF of power systems. However, conventional techniques suffer difficulties in passing over local optimal, divergence risk, constraints handling or computing higher order derivatives. Herein, the hybridization of Particle Swarm and Harmony Search Algorithm (PS – HSA) is developed for optimal capacitor planning to improve PF, and comparison is made with the Enhanced Particle Swarm Optimization (EPSO) and Improved Adaptive Harmony Search Algorithm (IAHSA). The test systems are the Modified IEEE 6 and 16 buses and nodes respectively. To create semblance of industrial load dominated power systems, the test networks were modified by increasing the reactive load demand at all buses of the IEEE 6 and 16 by 50% and 70% respectively. The capacitor is modelled as static shunt-controlled element deployed to inject reactive power at buses/nodes. Results show that for IEEE 6 buses, PF improved from 0.68 to 0.8983, 0.8986 and 0.8992 with EPSO, IAHSA and hybrid PS – HSA respectively. Similarly, in IEEE 16 nodes, PF improved from 0.76 to 0.9439, 0.943, and 0.944 with EPSO, IAHSA and hybrid PS – HSA respectively. Furthermore, real power losses reduced from 16.94 MW to 14.03 MW in IEEE 6 buses, translating to 17.2% reduction with the hybrid PS - HSA. While in IEEE 16 nodes, reduction is from 0.719 MW to 0.69 MW accounting for 4% reduction, also with the hybrid PS - HSA.
Comparative study of fetal weight estimation by various methods at term and its correlation with the actual birth weight
Authors: Singh Anjali , K. Srivastava Anjani , Singh Ankit
Published: October 2023

INTRODUCTION: Modern obstetrics aims to achieve the best quality of life for both mother and her unborn child. Birth weight is an important predictor of neonatal outcome, and its prenatal estimation plays a significant role in the comprehensive evaluation and management of high- risk pregnancies. This study aims to estimate fetal weight using different clinical methods and ultrasonography and compare these methods with the actual birth weight.

METHODS: A prospective cross-sectional comparative study of 200 full-term pregnant women admitted to the Northern Railway Central Hospital, New Delhi, between June 2014 and June 2015 was conducted. Patients in whom delivery was anticipated and completed within 1 week were included. Fetal weights were estimated clinically using Insler’s and Johnson’s formula and ultrasound using Hadlock’s formula. Estimates were then compared with actual birth weight. RESULTS: Both the clinical methods showed underestimation of fetal weight, while ultrasound estimation of fetal weight showed overestimation. Clinical methods had a lower average error in fetal weight estimation than ultrasonography methods. Reliability statistics showed a better prediction of fetal weight if all three methods were used in conjunction.

CONCLUSION: Clinical methods were found to be better than the ultrasonography method for fetal weight estimation. Clinical methods are easy and cost-effective for the patients, so all relevant health workers should be taught how to undertake this skill competently. However, all the methods must be used in conjunction.