bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular Classification of Vulvar Squamous Cell Carcinoma and Precursor Lesions Using Immunohistochemistry
Authors: Vinothini R. Pon Vigna , Bhandari Trilok Prasad Singh , Saksena Ajesh Raj , Swain Meenakshi
Published: October 2024

Introduction:

Vulvar malignancies are very rare. Two pathogenic pathways have been described in the development of vulvar squamous cell carcinoma.One is related to HPV infection and the other is related to TP 53 mutation. HPV infection related squamous cell carcinomas have a good prognosis and squamous cell carcinomas related to TP 53 mutation have the worst prognosis. Recently a third pathway which is neither HPV dependent nor p53 mutant has been identified. This pathway is found to have intermediate prognosis with better clinical outcome.

Aims:

The aim of this study was to classify vulvar squamous cell carcinoma and its precursor lesions molecularly using two immunohistochemical stains p16 and p53 in a cohort of South Indian population.

Subjects and Methods:

A retrospective observational study was conducted between January 2011 and December 2020 in the department of histopathology at a tertiary care hospital in Hyderabad, India. A total of 22 cases including all the vulval biopsies with suspected squamous cell carcinoma or precursor lesions and excision specimens operated for squamous cell carcinoma were included in this study. Paraffin blocks of representative cases were stained with hematoxylin and eosin stain, p16 and p53 immunohistochemistry (IHC) stains.

Results:

Out of 22 cases, two cases (9.0%) were precursor lesions of the vulva and 20 cases (90.9%) were invasive squamous cell carcinoma. Eleven (50%) of these cases were p53 mutant (p53+/p16−), 10 (45.4%) of these cases were HPV positive (p16+/p53−), and one of these cases (4.5%) was neither HPV positive nor p53 mutant (p16−/p53−).

Conclusions:

Classification of vulvar squamous cell lesions molecularly using simple immunohistochemical stains in routine diagnostic workup will aid in risk stratification of patients and help in their management and prognostication.
Pattern of kidney diseases admission and outcome in Bauchi, Northeast Nigeria: a 2 year review
Authors: Alhaji Abdu , Murtala Umar , Mahmood Maigari I. , Audi Yakubu K. , Rabiu Tanko , Baba Shamaki R.
Published: October 2024

Background

Kidney diseases are a heterogeneous group of disorders which if left untreated could lead to chronic kidney disease (CKD) which inadvertently progress to end-stage kidney disease. Renal replacement therapy for end-stage kidney disease is unaffordable, not widely available and require huge financial resources. Knowledge of the prevailing type of kidney disease will help to develop measures of prevention of the disease. This study aims to evaluate the burden and pattern of kidney disease and to determine its outcome over a 2 year period.

Patients and methods

This is a retrospective study of kidney diseases admission and outcome at Abubakar Tafawa Balewa university teaching hospital over a 2 year period. All case files of patients admitted were retrieved and those with diagnosis of kidney disease were evaluated.

Results

One thousand and nineteen patients were admitted during the period, 98 of which had kidney disease diagnosis, with 10.4% disease burden. The mean age of the patients was 48.71 ± 12.2 years. CKD accounted for 51% of the total admission, followed by urinary tract infection, acute Kidney injury, Nephrotic syndrome, and Nephritic syndrome each accounting for 19.3, 15.4, 9.2, and 5.1%, respectively. Overall six (10.5%) patients died on admission.

Conclusion

The burden of kidney disease is high in our study and is mainly due to high prevalence of CKD that affects younger age group.
Comprehensive insights into diabetic nephropathy: pathophysiology, clinical features, and emerging treatments
Authors: Habli Mohamad M.
Published: October 2024

Diabetic nephropathy (DN) is a leading cause of chronic kidney disease and end-stage renal disease globally, affecting 20–50% of diabetic patients. DN is characterized by albuminuria, retinopathy, and progressive reduction in glomerular filtration rate. The pathophysiology involves chronic hyperglycemia, protein glycosylation, mesangial matrix deposition, glomerular hemodynamic alterations, cytokine release, and renin-angiotensin-aldosterone system activation, leading to kidney damage. Differences in DN mechanisms between type 1 and type 2 diabetes are influenced by additional factors such as aging, obesity, and dyslipidemia. Prevention strategies focus on lifestyle modifications and regular screening. Pharmacological management includes tight glycemic control, blood pressure regulation, renin-angiotensin-aldosterone system blockade, and novel agents like sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists. Emerging therapies targeting inflammatory pathways and innovative medications offer promising avenues for future research. Comprehensive management integrating early detection and advanced pharmacological interventions is crucial to mitigating DN progression and improving patient outcomes.
Depression and associated factors in chronic kidney disease patients in southern Nigeria: a cross-sectional study
Authors: Osunbor Osariemen A. , Unuigbe Evelyn , Adejumo Oluseyi A. , Okaka Enajite I.
Published: October 2024

Background

The most common psychological problem encountered in patients with chronic kidney disease (CKD) is depression. However, it is often undiagnosed and undertreated in this group of patients. The prevalence of depression in pre-dialysis CKD patients and its associated factors were determined in this study

Patients and methods

This was a cross-sectional study that determined the prevalence of depression in pre-dialysis CKD patients using the Hamilton-Depression rating scale. Associated factors with depression were determined by logistic regression. P value less than 0.05 was taken as a significant

Results

A total of 250 CKD patients with a mean age of 52.3 ± 16.0 years were studied. They comprised of 116 (46.4%) males. Fifty-six (22.4%) of the study participants had depressive symptoms. Depression was significantly more common in those who were unmarried (38.3% vs. 18.7%; P= 0.002) and those whose duration of CKD was less than 6 months (26.6% vs. 15.2%; P= 0.026). Depression was significantly associated CKD stage (P=0.002). The significant factors associated with depression in the CKD patients were being unmarried (adjusted odds ratio: 2.54; confidence interval: 1.19–5.42; P= 0.02) and CKD stage (adjusted odds ratio:3.81; confidence interval: 1.50–9.83; P=0.01).

Conclusion

Depression is common in the pre-dialysis CKD population and its screening should be included in the evaluation and management of all pre-dialysis CKD patients.
Evaluation of effect of low-level laser therapy on alleviation of pain in patients with implant-supported mandibular overdenture: A pilot study
Authors: Makker Raveena , Srivastava Rajeev , Khandelwal Sourabh , Reddy Prashanthi
Published: October 2024

Aim:

Rehabilitation of edentulous jaws with implant-supported overdenture has achieved a comprehensive acclamation across the globe due to compromised retention and stability in conventional complete dentures. In dentistry, low-level laser therapy (LLLT) has become a viable treatment option for lowering inflammation, easing pain, and speeding up wound healing. This study aimed to evaluate the effect of LLLT on alleviation of pain in patients with two implant-supported mandibular overdentures.

Study Setting and Design:

This study was carried out in the Department of Prosthodontics at Index Institute of Dental Sciences, Indore, Madhya Pradesh. Completely edentulous patients willing for implant-supported mandibular overdenture and who gave consent, were enrolled.

Materials and Methods:

A total of ten implants were placed in five patients with completely edentulous mandibular arch willing for implant-supported mandibular overdenture. Individuals from the outpatient division of Department of Prosthodontics, Crown & Bridge, Index Institute of Dental Sciences, Indore were chosen as patients. Bilateral implants were inserted into the mandible at locations B and D. On the experimental side, low-level laser therapy (wavelength 810 nm) was administered immediately following implant insertion and on the third day. Over the course of 72 hours, pain after surgery was assessed using visual analogue scale (VAS) values, beginning at baseline.

Statistical Analysis Used:

The Mann-Whitney U test was used for statistical analysis of the intergroup pain alleviation scores.

Results:

The results showed that on intergroup comparison, the experimental side exhibited significantly reduced VAS pain scores relative to the control side (P<0.05).

Conclusion:

LLLT can be used as a promising adjuvant therapy to lower the degree and duration of pain after undergoing dental implant surgery.
Bond strength of polymer clay with room temperature vulcanizing maxillofacial silicone – An in vitro study
Authors: Palaskar Jayant N. , Hindocha Amit Dhansukhlal , Nalawade Tejas V. , Khurana Shrishti R. , Patankar Anupama , Shah Naisargi
Published: October 2024

Aim:

To assess and analyze the bond strength of polymeric organic clay and heat polymerized PMMA with RTV maxillofacial silicone with and without an adhesive primer.

Settings and Design:

The use of polymeric clay as a substructure for implant retained maxillofacial silicone prosthesis is suggested. However, the bond strength of polymeric clay with room temperature vulcanizing (RTV) maxillofacial silicone and heat polymerized polymethyl methacrylate(PMMA) with RTV maxillofacial silicone has yet to be studied.

Materials and Methods:

Fifty two samples were prepared in total. Group 1 (n = 13) silicone and PMMA without primer. Group 2 (n = 13) silicone and PMMA with primer. Group 3 (n = 13) silicone and polymer clay without primer. Group 4 (n = 13) silicone and polymer clay with primer. The samples were of dimensions of 75 mm × 10 mm × 3 mm. For groups 1 and 2, samples were fabricated with PMMA over which RTV silicone was manipulated, packed and vulcanized for 24 h. For Groups 3 and 4, polymer clay was molded to the required dimensions and hardened. RTV maxillofacial silicone was manipulated and packed over it and vulcanized. For Group 2 and 4 samples, primer was applied to the uncovered part of PMMA and polymeric clay respectively. The samples were subjected to a 180° and 90° (t peel test) peel strength test, respectively.

Statistical Analysis Used:

One way analysis of variance was used to analyze bond strength, which was then followed by a post hoc Tukey’s test.

Results:

The mean bond strength of silicone and PMMA without primer was 0.35 ± 0.07 mN/m, while silicone and PMMA with primer had a mean bond strength of 0.41 ± 0.04 mN/m. The mean bond strength of silicone and polymer clay without primer and silicone and polymer clay with primer was found to be 0.45 ± 0.13 mN/m and 0.30 ± 0.05 mN/m, respectively. An 80% research power and a 95% confidence interval were used in the statistical analysis. A significance threshold of P < 0.05 was applied.

Conclusion:

The silicone to heat polymerized PMMA primer bond strength is the same as the silicone to polymer clay primer bond strength. Bond strength of polymer clay and maxillofacial silicone without primer is better than with primer. Therefore, without primer application, polymer clay substitutes PMMA as an interface between maxillofacial silicone material and attachments/keepers.
Gingival acquired lymphangiectasia as a long-term effect of post-oncology intervention: A 20-year institutional audit
Authors: Ramani Pratibha , Ramasubramanian Abilasha , Kizhakkoottu Suvarna , Benitha Georgia
Published: October 2024

Background:

Gingiva is a keratinised mucosa akin to the skin and is exposed in all modalities of treatment of oral cancer. Acquired lymphangiectasia are acquired dilatations of lymphatic channels secondary to an external cause. They are extremely rare in the oral cavity despite that oral cancers are treated with different treatment modalities.

Methods:

The archives of the Oral and Maxillofacial Pathology Department of our institute were retrospectively reviewed from 2001 to 2021. Of the 9566 cases of oral biopsies, 4596 were confirmed cases of oral cancer including salivary gland carcinoma. These cases were followed up for the presence of post-neoplastic and post-therapeutic gingival lesions.

Results:

Of the 4596 patients, <10% patients reported recurrence or new primary of squamous cell carcinoma in the gingiva. Two patients were histopathologically diagnosed with acquired lymphangiectasia of gingiva after 12 years following surgery and radiation therapy as treatment for oral squamous cell carcinoma and mucoepidermoid carcinoma, which has been described in our report for the first time in the literature.

Conclusion:

Even though acquired lymphangiectasia of gingiva is very rare, lymphatic malformations should be included in the clinical differential diagnosis of post-therapeutic gingival proliferative pathologies in order to ensure appropriate treatment and prevent over-diagnosis of this benign condition.
The potential calcium content of anchovy (Stolephorus sp.) on mandibular bone growth through osteoprotegerin expression analysis
Authors: Sugiharto Sumintarti , Salmah Shelly , Fauziah Eva , Ramadany Sri , Wajdiyah Ummi , Achmad Harun
Published: October 2024

Background:

Anchovy (Stolephorus sp.) is a commonly used food ingredient due to its high calcium content, which supports craniofacial growth. Calcium stimulates the formation of osteoblasts, which produce osteoprotegerin (OPG). OPG binds to RANKL, blocking RANKL–RANK bonding and limiting osteoclast development.

Objective:

The objective of this study was to analyze OPG expression in mandibular bones to assess the potential calcium content of anchovies.

Methods:

Three groups of 27 male Wistar rats were created: control, anchovy, and milk. After 40 days, the rats were decapitated, and their mandibular bones were surgically extracted, decalcified, and prepared for microscopic examination. The results showed a significant difference in OPG expression of rat mandibles between control, anchovy, and milk groups (P < 0.05), as determined by one-way analysis of variance (ANOVA). Tukey’s HSD test revealed a significant difference in the average quantity of rat mandibular OPG expression between the control group and each of the anchovy and milk groups, with probability values of 0.00 and 0.003 (P < 0.05), respectively. However, the average level of OPG expression in anchovy and milk groups did not differ significantly, as indicated by the probability value of 0.064 (P > 0.05).

Conclusion:

The mandibular development increases after feeding anchovies compared to the control group. Anchovy is not statistically superior to milk in terms of increasing mandibular development. However, as a high-calcium food, anchovy is well-suited to support children’s craniofacial development and growth.
Merkel cell: Friend or felon
Authors: Tandon Ankita , Singh Narendra N. , Gulati Nikita
Published: October 2024

Merkel cells are perceived as tactile receptors within skin and oral mucosa containing abundant intermediate filaments but lacking characteristic condensation of tonofilaments, hence are also referred to as non-keratinocytes. Merkel cell carcinomas (MCCs) are primary aggressive neuroendocrine neoplasms occurring in elderly individuals. Toker in 1972 reported MCC of skin pointing towards sweat glands as the source of origin which was later rectified by Tang with the aid of ultrastructural studies as Merkel cells to be a lineage of such tumours. Normally, Merkel cells are abundant in the gingiva and vermillion border of the lip and thus these are the common sites for this neoplasm. Histopathologically, MCC mimics varied other carcinomas, hence requiring a thorough diagnostic protocol. We present a case of challenging histopathology which on immunohistochemical analysis with a unique cytokeratin profile and neurofilament staining pattern helped in reaching a definitive diagnosis.
Comparing the release of growth factors when partially demineralized tooth matrix is mixed with platelet rich fibrin and injectable platelet rich fibrin: An in-vitro observational study
Authors: Gowda B H Harshitha , Krishna Ravishankar , Srinivasan Srikari , Astekar Madhusudan
Published: October 2024

Context:

Platelet concentrates are rich in growth factors that assist in regenerative medicine to promote healing and tissue regeneration. Similarly, partially demineralized tooth is a storehouse of many growth factors, assisting in bone regeneration. Hence, the present study aimed to quantify the release of growth factors from different platelet concentrates individually and when mixed with a partially demineralized tooth matrix.

Method:

Human growth factors such as bFGF, EGF, PDGF-AB, TGF-beta-1, and VEGF-A present in platelet-rich fibrin and injectable platelet-rich fibrin from young and old male and female donors were quantified separately. Then these platelet concentrates were then mixed with a partially demineralized tooth matrix, which was powdered using a Smart Dentin Grinder. An enzyme-linked immunosorbent assay was used for the quantification of growth factors.

Results:

The release of growth factors, such as platelet-rich fibrin and injectable platelet-rich fibrin, was not statistically significant; however, it was significantly greater when i-PRF was mixed with a partially demineralized tooth matrix.

Conclusion:

The study revealed that the expression of growth factors was significantly greater when a partially demineralized tooth matrix was mixed with injectable platelet-rich fibrin than when combined with platelet-rich fibrin.
From teeth to ethnicity: A neural network approach to predicting population of origin through dental traits and anomalies
Authors: Kataria Suraj , Shinkre Rohan , Jain Sonal , Saraswathy Kallur Nava , Sachdeva Mohinder Pal , Kumar KP Mohan
Published: October 2024

Background:

This study aimed to investigate the prevalence of dental traits and anomalies in five North Indian populations (Khas Bodhi, Jaat, Khatri, Garhwali, and Gujjar) and predict the population of origin based on these traits and anomalies for forensic applications.

Methods:

We assessed dental traits and anomalies in 454 individuals through intraoral examination. Neural network analysis was employed to predict the population of origin based on a combination of dental traits and anomalies.

Results:

Shovel-shaped incisors exhibited the highest prevalence among the studied traits and anomalies, occurring in 65.4% of the sample. Moreover, shovel-shaped incisors were found to be the most important predictor of population. Neural network analysis indicated that the most accurate population prediction among the studied populations was for the Garhwali origin, achieving a recall rate of 78.3%. While this may appear relatively low, it is crucial to emphasise that the proposed method serves as a corroborative tool for various forensic investigations.

Conclusion:

This study suggests that dental traits and anomalies can be valuable in predicting the population of origin within Indian populations for forensic purposes. The work enhances the forensic identification process by providing an additional layer of evidence for consideration in identifying both individuals and their ethnic backgrounds. Further research is necessary to enhance the robustness of prediction models.
Comparative histologic evaluation of teeth decalcified by conventional method versus microwave induced decalcification
Authors: Kerketta Rashmi , Shah Sonalee , Grihtlahare Himanta , Wasti Amit , Patel Swatantrata
Published: October 2024

Introduction:

Complete demineralization of hard tissues with preservation of organic components to retain their tissue architecture and to obtain thin section for histological examination is done by a process known as “decalcification”. Tooth decalcification may be achieved by subjecting the tissue to a decalcifying chemical agent and employing heat, vacuum, or electric current to enhance the procedure. Completion of decalcification is adjudged by determination of end-point. Histological examination of hard tooth tissues and pulp is essential for diagnosis of developmental pathologies, pulp pathologies, and forensic odontology analysis as well as for research purpose.

Aim:

In our study, we studied the time consumed for decalcification procedure by conventional decalcification method and with the microwave-assisted decalcification method for teeth, using 5% nitric acid, 5% trichloracetic acid, and 14% EDTA (Ethylenediaminetetraacetic acid), respectively, along with morphological preservation of dentin and pulp tissue by analyzing preservation of their issue structure (pulp shrinkage, odontoblastic layer damage) and staining efficacy (patchy staining) for the three types of decalcifying agents used.

Materials and Method:

The sample for this study included 120 freshly extracted teeth consisting of teeth of mandibular dentition. Samples were divided into two study groups:

Group I: Decalcified by Conventional method

Group II: Decalcified by Microwave method.

Each group consisted of, three sub-groups employing a different decalcifying agent from among the three decalcifying agents used, that is, 5% nitric acids, 5% trichloroacetic acid, and 14%EDTA respectively.

Result:

The difference in speed of decalcification for both groups showed significant result. In either group, decalcification was fastest using 5% nitric acid. The difference in number of decalcified teeth sections showing shrinkage of pulp was not statistically significant for both groups. Damaged odontoblastic layer was evident only in the teeth treated with 5% nitric acid by microwave method. Patchy staining was observed in a few samples of all sample groups except those decalcified with EDTA by conventional method but the results were not statistically different on intercomparison.

Discussion and Conclusion:

Our results are similar to those of previous studies and we found that microwave method is an option that can reduce the time of decalcification. Tooth tissue morphology also was noted to be well preserved with 5% trichloracetic acid and 14% EDTA in comparison to 5% Nitric acid.
Plummer–Vinson syndrome
Authors: Deepak Abhishek , Kaushik Atul , Anwar Shahzad , Chauhan Kshitij
Published: October 2024

Plummer–Vinson syndrome (PVS) is characterized by a triad of postcricoid dysphagia, upper esophageal webs, and iron deficiency anemia, mostly affecting middle-aged females. A 30-year-old female patient presented to the gastroenterology outpatient department with complaints of dysphagia for solid foods for 1 year, which increased over the last 4 weeks. She had iron deficiency anemia. Barium swallow revealed a single thin esophageal web at the level of C4–5 vertebrae. Upper gastrointestinal endoscopy confirmed this. The patient was diagnosed with PVS. PVS is known to be associated with esophageal or pharyngeal cancers such as squamous cell carcinoma. Thus, we recommend early diagnosis of PVS and close follow-up of these patients.
Effects of montelukast on clinical manifestations of coronavirus infection
Authors: Singh Ram B. , Fatima Ghizal , Chakravorty Saibal
Published: October 2024

Montelukast is an antiviral agent and anti-inflammatory agent used in the treatment of pro-inflammatory pulmonary diseases. Since coronavirus infection disease 2019 (COVID-19) involves mainly lung in majority of the patients, it may have a possible benefit among these patients. This report aims to emphasize about the role of montelukast in COVID-19 patients. After verbal consent and clearance from the ethics committee, all the patients (n = 6) presenting with common cold, fever, cough, and breathlessness, who were administered montelukast, were considered for entry to this study. The diagnosis of COVID-19 was confirmed via a positive reverse transcription-polymerase chain reaction test among all the patients. All the patients were given standard treatment including hydroxychloroquine 200 mg twice daily day 1 and then 200 mg daily for 5 days, azithromycin 250–500 mg twice daily for 7 days, Vitamin C 500 mg daily, and Zincovit 1 tablet daily for about 3 weeks. Clinical, radiological, and blood examinations were done in all the patients included in this report. All the patients were adults between 34 and 70 years, 3 females, and presented with fever, cough, breathlessness, and body ache simulating a respiratory tract viral infection. They were initially treated with levocetirizine and montelukast 10–20 mg twice or thrice daily, depending upon clinical status of these patients. Those patients who had lower oxygen saturation below 90% (n = 2) were also administered oxygen and cortisone (n = 2) for possible benefit. Only one patient was hospitalized and one was on noninvasive ventilation for 5 days due to lower oxygen saturation below 70%. All patients recovered. All patients received standard treatment for COVID-19, hence it is not clear that which treatment had provided the benefit. Since all patients received montelukast and only one was hospitalized, it poses the possibility that the role of montelukast should be examined in a large number of patients in phase II and phase III trials.
Chronic pulmonary thromboembolism in a patient of erythema nodosum leprosum treated with thalidomide and corticosteroid
Authors: Singh Sangam , Mittal Mahim , Awasthi Minakshi , Chaudhary Neeraj
Published: October 2024

Thalidomide is the drug of choice for erythema nodosum leprosum (ENL) in men. Its use in patients with multiple myeloma has been reported to cause venous thrombosis. Postulated mechanism is an increase in procoagulant state with the use of thalidomide along with corticosteroids in the underlying hyperviscosity in multiple myeloma. We report a case of superficial and deep vein thrombosis and chronic pulmonary vein embolism in a patient of ENL treated with thalidomide and corticosteroid. An increase in procoagulant state with the use of these two medicines along with a persistent inflammatory state in ENL and an increased risk of venous thrombosis in type 3 hypersensitivity together may have resulted in thrombus formation.
Allergic bronchopulmonary aspergillosis misdiagnosed as other respiratory diseases
Authors: Prasad Rajendra , Rani Harshita , Shamim Huda , Kacker Rishabh , Gupta Nikhil
Published: October 2024

Allergic bronchopulmonary aspergillosis (ABPA) is a complex clinical entity resulting from an allergic immune response to Aspergillus fumigatus and most often occurring in a patient with asthma. Here in this article, we are reporting several cases of ABPA misdiagnosed as other respiratory diseases.
Effect of weekly practice of Laghu Shankhaprakshalana Kriya (yogic bowel cleansing) on appetite in healthy adults: An exploratory study
Authors: Negi Jaydeep , Bhardwaj Abhishek Kumar
Published: October 2024

ABSTRACT

Introduction:

Shankhaprakshalana (SP) kriya is one of the shatkarma (hatha yogic cleansing practices) used to cleanse the entire gastrointestinal tract with water. This technique involves the consumption of lukewarm saline water in conjunction with dynamic yoga asanas followed by a phase of deep relaxation. Past studies have reported the benefits of SP in managing digestive issues such as constipation, migraine-associated abdominal discomfort, and irritable bowel syndrome. However, there is a notable lack of literature investigating the impact of yoga-based cleansing practices on appetite status.

Objective:

This study aimed to investigate the effect of Laghu Shankhaprakshalana (LSP) kriya on the appetite status of healthy individuals.

Materials and Methods:

Sixty-five healthy male participants naïve to yoga with a mean age of 26.92 ± 5.35 years were recruited and randomly divided into an LSP group (n = 32) and a control group (n = 33). The LSP group engaged in LSP practice once a week for 8 weeks, while the control group received no intervention. Appetite status was assessed using the Council of Nutrition Appetite Questionnaire before and after completing eight sessions of LSP. The data were analyzed using the mixed model analysis of variance followed by post hoc Bonferroni correction for a total of 60 participants (five participants withdrew from the study).

Results:

Following eight sessions of LSP practice, a significant increase in appetite levels was observed (p < 0.001). No significant change was found in the control group.

Conclusion:

This study provides preliminary evidence suggesting that LSP practice tends to enhance appetite levels in apparently healthy individuals. Further research is needed with a larger sample and physiological assessment of appetite.
Recruitment Strategies To Improve Gender Equity in Clinical and Translational Research Training in Ethiopia
Authors: Hoover Alison T. , Woldeamanuel Yimtubezinash , Wassie Liya , Eyob Hiwet , Haile Mariam Damen , Kempker Russell R. , Blumberg Henry M. , Comeau Dawn L. , Bobosha Kidist
Published: October 2024

Women from sub-Saharan Africa, including Ethiopia, are underrepresented in biomedical research due in part to limited access to high-quality research training and mentorship. Tuberculosis (TB) is a major public health problem in Ethiopia, with a limited number of female Ethiopian scientists engaged in TB-related research. To improve access to TB-related research training among junior women scientists, our NIH Fogarty International Center-funded D43 program released an all-women request for applications (RFA), which substantially increased the number of women applying for research training and the number of women trained in our program. The impact of the all-women cohort was also bolstered by prominent female representation in mentor teams, program leadership, and program alumnae. Sustained increases in applications from women were seen in subsequent RFAs that included both women and men. Targeted leadership, mentorship, and recruitment efforts were effective in promoting improved gender equity in biomedical research training.
Blood-Feeding Patterns and Resting Behavior of Aedes aegypti from Three Health Districts of Ouagadougou City, Burkina Faso
Authors: Ouédraogo Wendegoudi M. , Zanré Nicolas , Sombié Aboubacar , Yameogo Felix , Gnémé Awa , Sanon Antoine , Costantini Carlo , Kanuka Hirotaka , Viana Mafalda , Weetman David , McCall Philip J. , Badolo Athanase
Published: October 2024

Recent dengue outbreaks have occurred in Ouagadougou and Bobo-Dioulasso, the two major cities of Burkina Faso. Dengue is a viral disease transmitted primarily by Aedes aegypti, a highly anthropophilic mosquito that thrives in human-transformed environments and breeds predominantly in artificial containers. In 2018, we investigated the resting and blood-feeding habits of Ae. aegypti in urban settings of Ouagadougou. In a 3-month cross-sectional study starting in August 2018, indoors and outdoors resting adult mosquitoes were collected using Prokopack aspirators in three health districts (HD). All mosquitoes were morphologically identified, and DNA was extracted from blood-fed Ae. aegypti females. A multiplex polymerase chain reaction with specific primers was used to identify the origin of the blood meal. A total of 4,256 adult Ae. aegypti mosquitoes, including 1,908 females, were collected. A preference for exophily was recorded in Bogodogo and Nongremassom, although an unexpectedly higher proportion of blood-fed females were found indoors than outdoors. Respectively, 96.09%, 91.03%, and 95.54% of the blood meals successfully analyzed in Baskuy, Bogodogo, and Nongremassom were from a single human host, with the remainder from domestic mammals as single or multiple hosts. Modeling total Ae. aegypti and blood-fed female counts showed that among other predictors, human density, outdoor environment, and house type affect their total densities. Our study revealed an exophilic tendency as well as a pronounced anthropophilic preference of Ae. aegypti adults, critical findings to consider when planning accurate entomological surveillance and effective interventions against Ae. aegypti in urban settings.
Enteric Fever with Intussusception, Myocardial Dysfunction, Encephalopathy, and Hemophagocytic Lymphohistiocytosis in an Indian Child
Authors: Awasthi Puspraj , Angurana Suresh Kumar , Nallasamy Karthi , Bansal Arun
Published: October 2024

Enteric fever is an endemic disease in developing and low-middle income countries due to poor sanitation and hygiene. The majority of cases have mild symptoms and resolve with oral or intravenous antibiotics. However, multisystemic involvement due to enteric fever requiring intensive care is not uncommon and is associated with high mortality and morbidity. We report a 5-year-old boy from Mohali, Punjab, India with enteric fever who had fulminant course with several complications including transient intussusception, myocardial dysfunction, encephalopathy, and secondary hemophagocytic lymphohistiocytosis. He was treated with ceftriaxone, vasoactive drugs, mechanical ventilation, dexamethasone, and intravenous immunoglobulin and had favorable outcome despite life-threatening complications.
Meet and Greet Sessions: A Unique Virtual Opt-Out Approach to Support Trainee Well-Being
Authors: Anand Uma , Kirshnit Carol , Rea Margaret
Published: October 2024

Background Interventions to support graduate medical education (GME) trainee well-being at the institutional level continue to be an area for continuous improvement.

Objective To assess participation, feasibility, and acceptability of a virtual, individual, brief, nonevaluative opt-out approach to accessing mental health support for residents and fellows.

Methods From 2021 to 2023, all GME programs at one large institution were invited to participate. During orientation, incoming trainees from programs that had communicated interest were prescheduled for optional 20-minute, virtual “meet and greet” sessions with a counselor from the hospital’s Employee Assistance Program. Nonformal feedback was gathered using an anonymous 6-question survey.

Results Three hundred thirty-four residents and fellows from 12 of 74 (16%) participating GME programs were prescheduled for opt-out sessions over 3 academic years. Of the 334, 182 (54%) attended the sessions, 116 (35%) subsequently reached out to start counseling, and 108 (32%) responded to the survey. Each year, approximately 7 counselor hours were needed for the opt-out sessions per week over an 8-week period, which was feasible and added no extra cost. In the follow-up survey shared with all participants, 59 of 81 (73%) respondents reported that the sessions helped to reduce barriers to seeking mental health care.

Conclusions During orientation, one-half of invited GME trainees participated in a virtual, individual, brief, nonevaluative meet and greet session with a counselor using an opt-out approach, and one-third subsequently requested counseling. Survey feedback was encouraging, and this approach can serve to help normalize culture surrounding accessing mental health services.
The Impact of Diagnosis-Specific Plan Templates on Admission Note Writing Time: A Quality Improvement Initiative
Authors: Rumlow Zachary , Almodallal Yahya , Zimmerman M. Bridget , Miner Rebecca , Asbury Rachel , Knake Lindsey A. , Schmitz Anna
Published: October 2024

Background There are limited objective studies regarding the effectiveness of strategies to alleviate the documentation burden on resident physicians.

Objective To develop and implement diagnosis-specific templates for the plan of care section of inpatient admission notes, aiming to reduce documentation time.

Methods Twelve templates for the plan of care section of admission notes were written by the study authors, reviewed by attending physicians, and shared with the residents through the electronic health record (EHR) on September 23, 2022. EHR audit log data were collected to examine admission note writing times, supplemented by resident feedback on acceptability via an anonymous survey. Feasibility measures included time investment, experience with the EHR, and resident training.

Results Between July 1, 2021 and June 30, 2023, 62 pediatric residents contributed 9840 admission notes. The templates were used in 557 admission notes. The mean total time spent on an admission note decreased from 97.9 minutes pre-intervention to 71.0 minutes post-intervention with the use of a template; an adjusted reduction of 23% (95% CI 16%-30%; P<.001). The mean attending time spent editing an admission note was unchanged. The survey results underscored wide acceptability of the templates among the residents. Feasibility data showed that the project required minimal time investment from the health care informatics team and minimal resident training.

Conclusions Using templates in the care plan section of admission notes reduces the time residents spend writing admission notes.
Burden of virologic failure, and its determinants among HIV positive children in East Africa: a systematic review and meta-analysis
Authors: Chekole Temere Bogale , Aynalem Mewahegn Agerie , Tefera Zewudie Bitew , Alebel GebreEyesus Fisha , Abebe Haymanot , Nuru Ahmed , Fetene Tamene , Tesfa Shegaw , Tsehay Tarekegn Tadesse , Kassaw Amare , Alebachew Wubet , Gelaw Walle Belete , Geze Tenaw Shegaw , Mesfin Yibeltal , Argaw Muche , Tsega Daniel
Published: October 2024

Background: There are many studies regarding the prevalence of Virologic failure and its associated factors in East Africa, but they are inconclusive. In this study, the prevalence of Virologic failure and its associated factors in east Africa were determined.
Methods: Published articles that were conducted in English language were prepared based on preferred reporting items for systematic reviews and meta-analysis (PRISMA) statement. Web of Science, PubMed, and Google Scholar were explored to find out the articles. STATA Version 14 software was used for computing the pooled estimates of both the prevalence of virologic failure and associated factors. The pooled estimates were computed using both random and fixed effect models. Results were presented by using the randomand fixed effect models. . The pooled estimates were presented with 95% CI. Publication bias was assessed by looking the symmetry in the funnel plot.
Result: The pooled prevalence of virologic failure was, 25.90 (19.49, 32.32, p ≤ 0:001) in the random effect model. Four factors, poor adherence (2.91 (Pooled odds ratio(POR): 2.91, 95%CI: 1.93, 4.40), being male (1.17 (POR: 1.17, 95%CI: 1.08, 1.27)), wasting as an under nutrition (3.1 (POR:3.1, 95%CI: 1.63, 5.95), and Nevirapine(NVP) based regimen (2.76 (POR: 2.76 (1.65,95%CI: 4.62)) were found to be independent predictors of virologic failure.
Conclusion: The prevalence of virologic failure in East Africa is remarkably high. Four factors were found to be the determining factors Different strategies must be designed to address (poor adherence, being male, wasting as an under nutrition, and NVP based regimen).
Keywords: HIV; virologic failure; adherence; viral load suppression.
Self-Reported Late Effects in Childhood Cancer Survivors in Kenya
Authors: Lemmen Jesse , Mageto Susan , Njuguna Festus , Midiwo Nancy , Langat Sandra , Vik Terry , Kaspers Gertjan , Mostert Saskia
Published: October 2024

Background: The number of children surviving cancer in low and middle-income countries is expected to grow in the coming years. Knowledge about late effects and follow-up preferences in Kenya is lacking.Objectives: This study assessed self-reported late effects in Kenyan childhood cancer survivors and explored their preferences for survivorship care.Methods: Childhood cancer survivors, having successfully completed treatment for at least one year, were interviewed using semi-structured questionnaires during clinic or home visits between 2021-2022. Medical records were reviewed for patient and treatment characteristics.Results: Twenty-six survivors of hematological malignancies (n=19, 73%), solid tumors (n=6, 23%), unknown tumor type (n=1, 4%), were interviewed. Most survivors (n=19, 73%) solely received chemotherapy and one survivor (4%) was irradiated. Median time since treatment completion was seven years. Fifteen survivors (58%) were previously lost to follow-up. Many survivors (n=19; 73%) self-reported late effects, predominantly pain and fatigue. Survivors (n=11, 42%) were limited in daily life activities: physical work (n=10, 38%), personal care (n=6, 23%), social activities (n=6, 23%). Eight survivors (31%) recalled being informed about late effects. Some survivors experienced a negative attitude toward cancer in regional hospitals. Follow-up duration was longer among informed patients (p=0.043). Survivors recommended education and survivor meetings and preferred their follow-up to be done at the referral center.Conclusions: Kenyan childhood cancer survivors self-report late effects, comparable in frequency, nature and severity to other survivors worldwide. Survivors and healthcare providers require education about the lifelong impact of childhood cancer and should have access to survivorship expertise to continue follow-up.
Keywords: Pediatrics; survivorship; neoplasms; aftercare.
Epidemiology of congenital malformations in Tunisian liveborns: a retrospective study
Authors: Nasri Kaouther , Ben Jamaa Nadia , Aloui Mariem , Mansouri Safouane , Sdiri Yosra , Cheour Mariem , Kacem Samia
Published: October 2024

Objective: To identify the various congenital malformations in liveborns in the neonatology service within the center of maternity and neonatology of Tunis (CMNT).
Methods: This is a retrospective study of liveborns with congenital malformations hospitalized during one year from 1rst January to 31 December 2016.
Results: The profile of malformations was dominated by polymalformations (22.29%), followed by chromosomal aberrations (21.14%), cardiovascular malformations (16.00%), and system nervous malformations (11.43%). Comparisons of liveborns and parental characteristics between all congenital malformations subtypes have shown significant differences in liveborns sex, consanguinity, and maternal age. Comparisons between malformed newborns and malformed fetuses have shown significant differences in  consanguinity, rhesus type, maternal origin and parity.
Conclusion: It seems important to set a careful surveillance of pregnancies at risk of developing congenital anomalies, systematic supplementation of vitamins and folic acid, and a national registry of congenital malformations.
Keywords: Congenital malformations; liveborns; risk factors; prevention; Tunisia.
Prevalence and factors associated with depression and suicidal ideation among people with diabetes mellitus and hypertension in Uganda
Authors: Nkola Rahel , Mohan Kaggwa Mark , Muwanguzi Moses , Kule Moses , Zari Rukundo Godfrey , Ashaba Scholastic
Published: October 2024

Background: Depression and suicide ideation are more common among patients with chronic physical illness including diabetes mellitus (DM) and hypertension (HTN). Depression is often undetected, underdiagnosed, and undertreated during routine care and may complicate into suicidal ideation in this population. This study aimed to determine the prevalence of depression and suicidal ideation, and associated factors among people living with DM and /or HTN in Uganda.
Methods: We enrolled 512 participants and assessed depression using PHQ-9 , and suicidal ideation using item 9 of PHQ-9. We run logistic regression models to determine the factors associated with depression and suicidal ideation among those with DM only, HTN only or both.
Results: The overall prevalence of depression and suicidal ideation was 22.07% and 10%, respectively. Among participants with both DM&HTN the prevalence of depression was 26.3% while 30.4% had comorbid suicidal ideation. Fear of complications (AOR = 7.21; 95% CI =2.68-19.39; p = 0.01) was significantly associated with depression. Adherence on antidiabetic medications (AOR = 0.10; 95% CI = 0.02-0.72; p = 0.02) was protective against depression.
Conclusion: The prevalence of depression and suicidal ideation among patients with DM and/or HTN in Uganda is high.
Keywords: Depression; suicidal ideation; diabetes mellitus; hypertension; Uganda, sub-Saharan Africa.
Prevalence and pattern of antibiotic use and resistance among Iraqi patients: a cross-sectional study
Authors: Talib Hashim Hashim , Talib Hashim Ali , Tharwat Ali Hossam , Mohamed Haya , Elrefaey Ahmed , Lmamoury Ameer , Aji Narjiss
Published: October 2024

Background: According to The Centers for Disease Control and Prevention (CDC) 2019, around 32,000 deaths in addition 2.8 million infections occur annually in the US because of antibiotic-resistant bacteria.
Objectives: To determine the prevalence and study pattern of antibiotic use and resistance among Iraqi patients.
Methodology: We carried out a cross-sectional study from January 2021 to October 2022 including data of 850 patients at different private and general hospitals, primary health centers, and private clinics. The data was collected during the patient’s admission or visiting time using medical records and mini-interviews.
Results: Escherichia coli and Staphylococcus aureus were the most detected pathogens in our sample in 14.5% and 11.29% of the patients respectively. Most patients (87.18%) had taken over-the-counter antibiotics previously. Around 55% of the antibiotics that were tested were resisted among our patients who were included in 2021. This percentage has increased to about 75% of the included patients in 2022. Amoxicillin was the most resistant antibiotic (77%) in our sample while meropenem was the least resistant among the tested antibiotic (5%).
Conclusion: Antibiotic resistance is a major public health concern that is often caused by the overuse and misuse of antibiotics, as well as poor infection control practices.
Keywords: Antibiotic; resistance; Iraq.
Fatal poisoning by dietary supplements accompanied by massive rhabdomyolysis and multiple organ failure = Śmiertelne zatrucie suplementami diety przebiegające z masywną rabdomiolizą i niewydolnością wielonarządową
Authors: Fogiel Oskar , Rak Małgorzata , Picheta Sebastian , Wachholz Paulina , Skowronek Rafał , Sein Anand Jacek , Pawlas Natalia
Published: October 2024

Obesity epidemic and prevailing standards of desired body shape encourage society to use weight loss aids. Thermogenics, which are dietary supplements aimed at increasing energy expenditure, are particularly gaining popularity. These preparations can be easily purchased without prescription and have a complex composition, which means they can interact with numerous substances. The article describes the case of a 31-year-old female patient who, in a suicide attempt, ingested significant amounts of the dietary supplements ‘Blue Magic’ and ‘Purim’. Both supplements contain, among other ingredients: caffeine, yohimbine, reserpine, and synephrine. The patient developed multiple organ failure, which led to her death on the second day of hospitalization. Poisoning by dietary supplements, due to their diverse composition and the lack of correlation between the content and the composition declared by the manufacturer, can pose a significant threat to the health and life of consumers.