bluuebunny/crossref_metadata_2025 huggingface dataset:
Laparoscopic training on virtual-reality simulators or live pigs—a randomized controlled trial
Authors: Bian Zhengqian , Zhang Yan , Ye Guangyao , Guo Feng , Mu Yifei , Fan Yinghui , Zhou Xiang , Zheng Qing , Konge Lars , Wang Zheng
Published: August 2023

Background:

This randomized controlled trial compared the efficacy of virtual-reality (VR) simulator training and surgical training on live pigs to explore the most effective and evidence-based training modality.

Materials and methods:

Thirty-six novice surgical residents without independent laparoscopic experience were randomly paired with a peer and randomized into three groups: VR simulator group (dyad training on LapSim VR simulators), pig surgery group (training on live, anesthetized pigs) and control group (training by a lecture on laparoscopic surgery, surgical videos and textbooks). After 6 h of training, all participants performed a simulated cholecystectomy procedure using a pig liver with adherent gallbladder working in pairs. All procedures were video-recorded and the recordings were saved on USB-sticks in a blinded fashion identifiable only by the unique participant number. All video-recordings were scored blindly and independently by two expert raters using the Global Operative Assessment of Laparoscopic Skills (GOALS) assessment instrument.

Results:

The performances in the three groups were significantly different, P less than 0.001. Both the VR simulation training group and the live pigs training group performed significantly better than the control group, both P values less than 0.001. However, there was no significant difference in the performance of the two simulation-based training groups, P=0.66.

Conclusion:

Novice surgical trainees can benefit from both VR simulator training and pig surgery simulation compared with traditional studying and there was no significant difference between the two modalities. The authors recommend that VR simulators should be used for basic training of laparoscopic skills and surgery on live animals should be reserved for higher-level surgical training.
In-silico approach to designing effective antiviral drugs against SARS-CoV-2 and SARS-CoV-1 from reported phytochemicals: a quality improvement study
Authors: Tuz-Zohura Fatema- , Shawon Abu R.Md. , Hasan Md. Maruf , Aeyas Abdullah , Chowdhury Faisal I. , Khandaker Mayeen U.
Published: August 2023

Computer-aided drug design by molecular docking, statistical analysis like multiple linear regression (MLR), principal component analysis (PCA), and molecular dynamics studies can emerge as an efficient approach to designing promising core scaffolds for coronavirus medication. The main protease [3-chymotrypsin-like protease (3CLpro)] of severe acute respiratory syndrome coronavirus (SARS-CoV)-1 and SARS-CoV-2 is one of the critical targets for designing and developing broad-spectrum antiviral therapeutic drugs. The main objective of this study was to investigate potential phytochemicals against SARS-CoV-1 and SARS-CoV-2 to ensure effective natural product-induced therapy. In this evaluation, we have selected 40 reported phytochemicals to design efficient core scaffolds that can act as potent inhibitors against the main proteases of SARS-CoV-2 and SARS-CoV-1. We categorized the selected phytochemicals into a more bioavailable and less bioavailable set, considering phytochemical drug likeliness properties. All the selected phytochemicals vigorously interacted with the catalytic dyads His41 and Cys145. Statistical analysis by MLR confirmed their contribution to structural features on binding affinities and PCA analysis for structural activity relationships for their structural pattern recognition to determine the core scaffold inhibitors. We confirmed that 4′-Hydroxyisolonchocarpin and BrussochalconeA were safe and exhibited excellent pharmacological properties. Because 4′-Hydroxyisolonchocarpin and BrussochalconeA are flavonoid derivatives, they exhibit the chalcone’s ring. The presence of the reactive α,β-unsaturated system in the chalcone’s rings showed different potential pharmacokinetics with an insignificant toxicological profile. Our comprehensive computational and statistical analysis reveals that these selected phytochemicals (4′-Hydroxyisolonchocarpin, BrussochalconeA) can be used to design potential broad antiviral inhibitors against SARS-CoV-2 and SARS-CoV-1.
Clinical characteristics and management outcomes of Guillain-Barré syndrome: eight-year experience at a tertiary center in jordan – a retrospective cohort study
Authors: Al-Hayk Kefah , Aqaileh Suha , Smadi Mahmoud M. , Yassin Ahmed , Aldabbour Belal , Al Qawasmeh Majdi , Kofahi Raid , Elamassie Samah , El-Salem Khalid
Published: August 2023

Background:

Guillain-Barré syndrome (GBS) is a major cause of acute flaccid paralysis that is encountered in all geographical areas. Very limited data about this syndrome has been reported from the Arab countries. This study is the first one trying to describe the clinical features and management outcomes of GBS in the Jordanian population.

Methods:

This retrospective study looks at adult patients admitted to a major tertiary referral hospital in the north of Jordan between 2013 and 2021.

Results:

A total of 30 patients met the inclusion/exclusion criteria. Males were predominantly affected (70%) with a male-to-female ratio of 2.33. Acute inflammatory demyelinating polyradiculoneuropathy variant was encountered in 60% of cases, whereas axonal variants, namely, acute motor axonal neuropathy and acute motor axonal and sensory neuropathy variants were seen in about 23% of cases. ICU admission was reported in 37% of patients and 6.7% required mechanical ventilation. Most patients had a favorable outcome with a GBS disability score of three or better at out-patient follow-up visits.

Conclusion:

Our cohort of patients showed a significant deviation in disease expression from that reported in other parts of the globe. This deviation was obvious in more prominent male predominance, frequencies of different GBS variants, and more favorable short-term morbidity/mortality outcomes. However, larger multicenter prospective studies are needed for confirmation of these results.
Case report peripheral ulcerative keratitis with nodular scleritis, presents as the primary manifestation of granulomatosis with polyangiitis
Authors: Bohara Dikshya , Sitaula Ranju Kharel , Sitaula Sanjeeta , Jha Saket
Published: August 2023

Introduction and importance:

Granulomatosis with polyangiitis (GPA) is an ANCA-associated autoimmune disorder that typically affects small and/or medium-sized blood vessels. Being a life-threatening disease, with timely suspicion, targeted laboratory investigations, and collaborative management from the ophthalmologist and rheumatologist led to long-term remission of the disease.

Case:

A 38-year-old female complaining of recurrent deep boring pain with redness in her left eye for many years, which was diagnosed as nodular scleritis with peripheral ulcerative keratitis. The patient also has recurrent bouts of epistaxis and in suspicion of GPA laboratory investigations were carried out and later diagnosed. She was started on cyclophosphamide and is currently under maintenance with rituximab.

Case discussion:

Ocular involvement has been shown to occur in 20–50% of the population in several studies. It causes conjunctivitis, episcleritis, scleritis, necrotizing keratitis, corneoscleral perforation, posterior uveitis, and optic neuritis. The positive C-ANCA and high PR3 autoantibody have high sensitivity and association with GPA. Cyclophosphamide has been shown to be an effective treatment in multiple studies whereas rituximab has been emerging as a new treatment modality for maintenance, which in turn helps in the remission and relapse of GPA cases.

Conclusion:

Scleritis and peripheral ulcerative keratitis can be the manifestation of a GPA. Careful evaluation, diagnosis, and management with a multidisciplinary medical team, early start of cyclophosphamide, and rituximab have a huge role in decreasing the disease activity and is life-saving.
Cytomegalovirus viremia in an 11-year-old child with sickle cell disease manifested only with fever: a case report
Authors: EID Mahfoud , Ghanem Abd , Saloum Elias
Published: August 2023

Introduction and importance:

Cytomegalovirus (CMV) is a widespread virus, and it affects people of all ages. Infection with this virus causes severe life-threatening disease in immunocompromised patients and newborns. While CMV infection is asymptomatic or present as a mild illness in most cases of immunocompetent patient, it may cause severe diseases in 10% of cases.

Case presentation:

Here, the authors describe the case of an 11-year-old male presented with an ischemic stroke due to sickle cell disease; who, during hospitalization, developed a prolonged fever. After excluding bacterial infections, infiltrating diseases, rheumatologic diseases, malignancies, and other possible causes, he was diagnosed with CMV infection, which not checked initially, because most cases are asymptomatic.

Conclusion:

This case highlights the need to consider CMV infection in the differential diagnosis of every case of fever of unknown origin, regardless of the patient’s immune status.
Magnitude of opportunistic infections and associated factors among adult people living with human immune deficient virus on art at selected public hospital, mogadishu somalia: cross-sectional study
Authors: Mohamud Abdirahman Khalif , Ahmed Omar Abdullahi , Mohamud Abdulrahman Ahmed , Dirie Najib Isse
Published: August 2023

Introduction:

Opportunistic infections (OIs) remain the leading cause of death among people living with Human immune deficient virus and OIs-related mortality in Africa is estimated at 310 000 cases. Besides, Somalia has scant data about OIs since a high burden of tuberculosis and HIV co-infection has been reported. Hence, up-to-date information is vital for better treatment and interventions and may support national and international HIV strategies and eradication programs. Therefore, this study aims to estimate the magnitude of OIs and determine factors associated with among people living with HIV/AIDs on anti-retroviral therapy (ART) in a selected public hospital in Mogadishu, Somalia.

Materials and methods:

A hospital-based cross-sectional study was conducted between 1 June and 30 August 2022 by interviewing HIV patients and reviewing case record files using a validated questionnaire containing sociodemographic, clinical, OIs history, behavioural and environmental characteristics. Logistic regression was used to determine factors associated with OIs at the significance level of a=0.05.

Result:

The magnitude of OIs among people living with HIV was 37.1% (95% CI=31.6–42.2); major identified OIs were pulmonary tuberculosis 8.2%, Diarrhoea 7.9%, and Pneumonia 4.3%. Based on Multivariable logistic regression drinking non-sterilized water [adjusted odds ratio (AOR)=2.395, 95% CI: 2.010–4.168], living with domestic animals (AOR=4.012, 95% CI: 1.651–4.123), Co-morbidity of chronic disease (AOR=2.910, 95% CI: 1.761–3.450), and poor ART adherence (AOR=3.121, 95% CI: 1.532–6.309) were factors associated with OIs.

Conclusion:

Human immune deficient virus patients in Mogadishu, Somalia, suffer from OIs. The OIs reduction strategies should improve drinking water sanitation, provide special consideration for those living with domestic animals and those with a co-morbid chronic disease, and improve ART adherence.
Amyotrophic lateral sclerosis with respiratory failure and dysautonomia: a case report
Authors: Chapagain Subodh , Khati Nirajan , Lama Roshani , Karki Rikesh , Aryal Roshan , Pangyani Binaya , Koirala Anupam
Published: August 2023

Introduction and importance:

Amyotrophic lateral sclerosis (ALS) is a disease that affects both upper and lower motor neurons, causing a range of symptoms beyond the motor system. Recent research has shown that the autonomic nervous system can also be affected, with symptoms such as orthostatic hypotension, fluctuations in blood pressure, and dizziness being reported.

Case presentation:

A 58-year-old male presented with left lower limb limping, difficulty climbing stairs, and left foot weakness, followed by right upper limb weakness and was diagnosed with ALS and received edaravone and riluzole treatment. He presented again with right lower limb weakness, shortness of breath, and wide fluctuations in blood pressure, leading to ICU admission with new diagnosis of ALS with dysautonomia with respiratory failure and was managed with non-invasive ventilation, physiotherapy, and gait training exercises.

Clinical discussion:

ALS is a progressive neurodegenerative disease affecting motor neurons but non-motor symptoms can also occur, including dysautonomia, which can result in blood pressure fluctuations. Dysautonomia in ALS is caused by several mechanisms such as severe muscle atrophy, prolonged ventilatory support, and upper and lower motor neuron lesions. Management of ALS involves giving a definitive diagnosis, providing nutritional support, using disease-modifying drugs such as riluzole and non-invasive ventilation to improve survival and quality of life. Early diagnosis is essential for effective management of the disease.

Conclusion:

Early diagnosis, use of disease-modifying drugs, non-invasive ventilation, and maintaining the patient’s nutritional status are crucial for managing ALS which can have non-motor symptoms as well.
Frosted branched angiitis due to viral meningo-encephalitis and ocular toxoplasmosis; a rare case report from Nepal
Authors: Sitaula Ranju Kharel , Shah Chiranjiwi Prasad , Shrestha Saurav Man
Published: August 2023

Introduction:

Frosted branched angiitis (FBA) is characteristic florid translucent retinal perivascular sheathing of both arterioles and venules in association with variable uveitis and vasculitis affecting the entire retina. The vascular sheathing is supposed to be an immune-mediated reaction, possibly due to immune complex deposition in vessel walls secondary to various underlying etiologies. The authors aim to report a case of FBA secondary to herpes simplex virus and Toxoplasma gondii infection causing the diagnostic dilemma. This is the first case report on FBA from Nepal.

Case report:

An 18-year-old young boy hospitalized with the diagnosis of acute viral meningo-encephalitis presented with the complaint of diminution of vision and floaters in both eyes for a week. Herpetic infection was confirmed with the cerebro-spinal fluid analysis and was under antiviral drugs. His presenting visual acuity was 20/80 in both eyes and ocular features were suggestive of FBA. The vitreous sample analysis revealed raised toxoplasma titre so intravitreal clindamycin was administered twice. The ocular features resolved in the subsequent follow ups with intravenous antiviral treatment and intravitreal antitoxoplasma treatment.

Conclusions:

FBA is a very rare clinical syndrome secondary to many immunological or pathological causes. So, possible etiologies must be ruled out for timely management and good visual prognosis.
Liver injury: the therapeutic dilemma of homeopathy – a case report from Bangladesh
Authors: Shrestha Abhigan B. , Karki Bikash , Acharya Prakash , Kafley Shashwat , Shrestha Nabaraj , Karki Shailendra , Acharya Surya K.
Published: August 2023

Despite the lack of scientific evidence supporting its effectiveness, homeopathic treatment is increasingly being used as a form of alternative medicine, with many people taking homeopathic remedies instead of drug therapies. It is based on the principle of ‘like cures like’, meaning that a remedy similar to the illness can be used to treat it. However, there have been several reports suggesting the risks of homeopathic remedies, among which homeopathy-induced liver injury is widely discussed. Here, we report a case of a 35-year-old well-oriented male patient with a typical clinical presentation of liver injury as presented by yellowish discoloration of sclera and skin along with generalized body itching following the use of homeopathic medicine for musculoskeletal pain. Laboratory reports of increased liver markers along with bilirubin were also suggestive. Excluding other differentials like viral hepatitis, alcoholic hepatitis, hemochromatosis, Wilson disease, and standard drug and toxin-induced hepatitis, the recent use of homeopathic remedies was a contributing factor in leading to the diagnosis of homeopathy-induced liver injury. He was then treated with the discontinuation of homeopathic medicine and supportive care. This case highlights the need for public awareness of the possible complications such as headache, tiredness, skin eruption, dizziness, bowel dysfunction, allergic reactions to acute pancreatitis, renal failure, neurological dysfunction, possible liver injury, and even mortality in those patients who pursue homeopathic treatments and health care professionals should take this into account when making a differential diagnosis in patients with liver injury.
Relationship of microvascular density on histological and immunohistochemical features in endometrioid adenocarcinomas of the uterus: experimental study
Authors: Lуndіn Mykola , Kravtsova Olga , Sikora Kateryna , Lуndіna Yulia , Sikora Yana , Awuah Wireko Andrew , Hasan Mohammad M. , Abdul-Rahman Toufik , Sikora Vladyslav , Hyriavenko Nataliia , Romaniuk Anatolii
Published: August 2023

Background:

The most common malignant tumors of the uterus are endometrioid adenocarcinomas (EA). Their prognosis depends on the qualitative characteristics of the neoplastic cells and their stroma. The neovascularization of EA tissues and level of microvascular density (MVD) influence tumor progression. Our study aims to establish the relationship between MVD in EA tissue and the histological and immunohistochemical features of tumors.

Materials and methods:

The authors studied 30 cases of endometrial ЕА and compared their histological and immunohistochemical characteristics with the MVD of tumor tissues.

Results:

Our study indicated that MVD in EA tissue depends on the grade of the tumors and their FIGO stage. Increased MVD was correlated with a depression of E-cadherin and PR expression and enhanced expression of VEGF and Ki-67. MVD enhancement during VEGF overexpression is a manifestation of the functional activity of these proteins. The increase in MVD was accompanied by more frequent metastasis of the EA to the lymph nodes.

Conclusion:

EA progression is accompanied by qualitative and quantitative variations of parenchymal and stromal patterns of tumors. Dedifferentiation of EA leads to overexpression of VEGF, which becomes diffuse in tumors cells, resulting in an increase of adenocarcinomas’ MVD and their metastatic potential. Correlations between histological and immunohistochemical features of EAs indicate the synchronicity of the occurrence and progression of morphological and immunological anaplasia, which can be used in predicting the course of the disease.
Prevalence and clinical characteristics of pruritus, and the factors significantly associated with high pruritic intensity in patients with psoriasis: a cross-sectional study
Authors: Junsuwan Natchaya , Likittanasombat Surachanee , Chularojanamontri Leena , Chaiyabutr Chayada , Wongpraparut Chanisada , Silpa-archa Narumol
Published: August 2023

Background:

Despite the significant prevalence of pruritus in psoriasis, its pathogenesis remains unknown, and research on pruritus in Thai psoriasis patients is limited.

Objectives:

The objective was to investigate the prevalence and clinical characteristics of pruritus, and the factors significantly associated with high pruritic intensity in Thai psoriasis patients.

Material and methods:

In a cross-sectional study design, pruritus data were collected from the medical records of patients who attended an outpatient psoriasis clinic in Thailand between 2020 and 2021.

Results:

The overall prevalence of pruritus was 81.2% among 314 psoriasis patients. Psoriasis patients with pruritus had higher Psoriasis Area Severity Index and Dermatology Life Quality Index scores than those without pruritus. The legs, back, arms, and scalp were the most common areas for pruritus. Pruritus was relieved with topical emollients, topical corticosteroids, and oral antihistamines in 66.3, 63.1, and 52.9% of patients, respectively. Female sex, psoriasis body surface area greater than or equal to 10%, and genital psoriasis were factors that independently predicted high pruritus intensity.

Conclusion:

Psoriasis patients should be screened and treated for pruritus to improve both psoriasis treatment outcomes and patient quality of life. Further studies are needed to clarify the most effective medications for pruritus in patients with severe psoriasis.
Cerebrovascular disease in patients with COVID-19 infection: a case series from Lebanon
Authors: El Mawla Zeinab , El Saddik Ghaidaa , Zeineddine Maya , Hassoun Mahmoud , El Hajj Taghrid
Published: August 2023

COVID-19 has been associated with a variety of multi-organs complications, with an increasing proportion of patients presenting with neurologic manifestations. There is still an uncertainty in the relationship between stroke and COVID-19. Therefore, in this study, the authors report 18 cases of acute stroke occurring in the setting of COVID-19 infection, including 11 ischaemic strokes and 7 haemorrhagic strokes and identified in a Lebanese tertiary hospital. In this case series, patients with ischaemic and haemorrhagic stroke had elevated markers of inflammation and coagulation. Ischaemic stroke patients were treated with different regimens of anti-platelets, anticoagulants, and thrombolytic therapies. Death was the most common outcome observed and was associated with the severity of COVID-19 infection.
Systemic chemotherapy combined with radiofrequency ablation for colorectal cancer with liver metastasis: a retrospective cohort study
Authors: Tran Thang , Nguyen Hoa Thi , Pham Giang Hoang , Thi Hoang Cuc , Vu Quan Duc
Published: August 2023

Background:

This study aims to evaluate the efficacy of systemic chemotherapy combined with radiofrequency ablation in the treatment of inoperable colorectal cancer with liver metastasis.

Materials and methods:

The authors conducted a retrospective cohort analysis on 30 patients diagnosed as colorectal cancer with liver metastasis who underwent systemic chemotherapy combined with radiofrequency ablation of the liver lesions from January 2017 to August 2020 at our institution. Responses was evaluated by International Working Group on Image-guided Tumor Ablation criteria, along with progression-free survival.

Results:

The response rate after 4 cycles and 8 cycles of chemotherapy were 73.3% and 85.2%, respectively. All patients achieved responses after of radiofrequency therapy, with the rates of complete response and partial response were 63.3% and 36.7%. The median progression-free survival was 16.7 months. After radiotherapy ablation, all patients had mild to moderate hepatic pain, 10% of patients had fever and increased liver enzymes occurred in 90% of patients.

Conclusions:

Systemic chemotherapy combined with radiofrequency ablation was safe and effective in colorectal cancer with liver metastasis and warrants further large-scale studies.
Gamma glutamyl transferase as a biomarker to predict contrast-induced nephropathy among patients with acute coronary syndrome undergoing coronary interventions: a meta-analysis
Authors: Javid Mona , Mirdamadi Arian , Javid Mohammadreza , Amini-Salehi Ehsan , Vakilpour Azin , Keivanlou Mohammad-Hossein , Porteghali Parham , Hassanipour Soheil
Published: August 2023

Background and aims:

The third most frequent reason for hospitalized acute kidney injury is contrast-induced nephropathy (CIN). Percutaneous coronary intervention (PCI) and coronary angiography (CAG) are two interventions that can result in CIN. In this study, we sought to determine how well gamma-glutamyl transferase (GGT) can predict CIN following CAG and PCI.

Method:

Two researchers searched through PubMed, Scopus, and Web of Science in November 2022 to find articles that examined GGT levels in CIN patients following PCI or CAG. To rate the quality of the studies, the Joanna Briggs Institute Critical Appraisal Checklist was employed. The Cochran test and I2 statistics were utilized to assess study heterogeneity. To calculate the number of participants required to reject the null hypothesis, power analysis was used. We evaluated the epidemiologic strength of the results using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The authors used Comprehensive Meta-analysis Version 3 to summarize the results.

Results:

GGT was shown to be considerably greater in patients with CIN according to the meta-analysis’s findings (odds ratio: 3.21, 95% CI: 1.26–8.15, P=0.014); nevertheless, the findings were accompanied by significant heterogeneity (I2=91.93%, P<0.001). Although the relationship between CIN and GGT was power full regarding power analysis (1- β =1, number of effect sizes=4, the average number per group=336), very low quality of evidence was observed regarding GRADE criteria.

Conclusions:

These results suggest the GGT level may be a predictor of contrast-induced nephropathy in patients having cardiac catheterization; however, more research is required to prove the epidemiological validity.
Stress-induced menstrual disorders in adolescents during the Ukrainian war: cross-sectional study
Authors: Mykolayivna Nikitina I. , Adebusoye Favor T. , Awuah Wireko A. , Anatoliivna Sinkina A. , Volodymyrivna Babar T. , Fedorivna Herasymenko S. , Abdul-Rahman Toufik
Published: August 2023

Objective:

The objective was to investigate the peculiarities of menstrual cycle changes in teenagers exposed to a devastating war for an extended period.

Methods:

A cross-sectional study of 120 Ukrainian girls aged 9–18 asked to complete a survey about their menstrual cycle status 3–6 months after the war began. Other examination methods used included anthropometry, laboratory, and instrumental studies.

Results:

The frequency of menstrual cycle disorders in the study group was 65.8% (n=79). The following menstrual cycle disorders were most frequently reported; dysmenorrhea 45.6% (n=36), excessive menstruation during puberty 27.8% (n=22), and secondary amenorrhea 26.6% (n=21). The 52.5% (n=63) of those examined had pathological menarche. The 81.7% (n=63) of respondents reported a change in eating habits in the previous few months. The 61.9% (n=39) of these children had dyshormonal disorders or met the criteria for metabolic syndrome.

Conclusion:

Adolescent females under stress warrant a quick assessment of their psychoemotional and metabolic conditions. The protection from future menstruation and reproductive illnesses depends on this tactic. By diagnosing these conditions promptly and well-managed, adolescent females may maintain good physical and emotional health.
A case report of bilateral benign Ovarian Fibrothecoma coincidental with ascites: an unconventional co-occurrence
Authors: Mohamad Raied , Al Laham Omar , Albrijawy Reham , Sallom Mostafa , Merhij Alhasan , Almousa Mohammad
Published: August 2023

Introduction and importance:

Ovarian fibrothecoma are a mostly benign and profoundly rare type of gonadal stromal cell tumor. It makes up 3–4% of all kinds of ovarian neoplasia. They are predominantly unilateral in origin and mostly present in women during the postmenopausal phase. Our case is especially important because the tumors occurred bilaterally and were associated with ascites. This seldom happens in patients with ovarian fibrothecoma. Early identification and treatment are key components to avoid the subsequent complications of this tumor.

Case presentation:

We present the case of a 54-year-old female who presented complaining only of a slow progressive increase in the abdominal contour associated with vague abdominal pain. Our preoperative radiological imaging revealed multiple ovarian and uterine masses.

Clinical discussion:

Surgical intervention in the form of a hysterectomy with bilateral salpingo-oophorectomy was achieved. Histopathological analysis revealed bilateral benign ovarian fibrothecoma with benign uterine leiomyomas. The patient underwent an uneventful postoperative recovery.

Conclusion:

Ovarian Fibrothecoma is a rare gynecological pathology. The uniqueness of our case stems from the rarity of its bilateral occurrence and in rare occasions, their occurrence is accompanied by ascites. This kind of co-occurrence should be differentiated from other rare presentations, such as Meigs Syndrome. Therefore, documentation is necessary to circumvent misdiagnoses and to abate the resulting patient morbidity. To further highlight the value of our case, it is to the best of our knowledge, the first documented case of this pathology from our country.
Difference in presentation, outcomes, and hospital epidemiologic trend of COVID-19 among first, second, and third waves: a review of hospital records and prospective cohort study
Authors: Mahmud Reaz , Islam Md. Ashikul , Haque Md. Emdadul , Hussain Dewan A. , Islam Mohammad R. , Monayem Farhana B. , Kamal Mohammad M. , Sina Hashmi , Islam Mohammad F. , Datta Ponkaj K. , Sayeed S.K. Jakaria B. , Dhali Sabbir A. , Islam Khairul , Ratul Rifat H. , Hossain S.K. Md. Rubaed , Prince Habib N. , Chowdhury Ahmed H. , Ahmed Kazi G.U. , Miah Md. Titu , Rahman Md. Mujibur
Published: August 2023

Background:

This study aimed to examine the differences in epidemiologic and disease aspects among patients with coronavirus disease-19 (COVID-19).

Methods:

The authors reviewed the hospital records between April 2020 and September 2021 and followed up on the patients for post-COVID complications.

Findings:

Older adult patients were predominantly affected during the third wave, and middle-aged patients were predominantly affected during the first and second waves. Men were predominantly admitted, considering the three waves, although more women were admitted in the second wave. Cough was more common in the second and third waves than in the first wave 522 (59.7%). Respiratory distress was the most common in the third wave, 251(67.1%), and least common in the first wave, 403 (46.1%). Anosmia was more common in the third wave 116 (31.2%). In the third wave, patients presenting in a critical state 23 (6.2%) and with severe disease 152 (40.8%) were more common. The hospital admission median (IQR) was longer in the first wave, 12 (8–20), than in other waves. More patients were admitted in the first wave (52%) than in the other waves, and patients received more oxygen in the third wave (75%) than in the other waves. Death occurred more commonly in the first wave (51%) than in the other waves. The positivity rate was higher in the third wave (22.8%) than in the other waves. In the third wave, the positivity rate was higher in women (24.3%) than in men. Post-COVID cough increased in the second wave, and fatigue was higher in the third wave than in the other waves. Tiredness and memory loss were greater during the second wave than in other waves.

Conclusion:

The authors found differences in the presentation, outcomes, and hospital epidemiologic trend of COVID-19 among the three waves.
A reflection of Africa’s cardiac surgery capacity to manage congenital heart defects: a perspective
Authors: Awuah Wireko A. , Adebusoye Favour T. , Wellington Jack , Ghosh Shankhaneel , Tenkorang Pearl O. , Machai Paciencia N.M. , Abdul-Rahman Toufik , Mani Shyamal , Salam Abdus , Papadakis Marios
Published: August 2023

Congenital heart defects (CHDs) are birth abnormalities that may drastically alter the structure and functionality of the heart. For 70% of infants with congenital disorders to survive or maintain a better quality of life, surgery is necessary. Over 500 000 of the 1.5 million CHD cases reported annually, or 1% of all live births, occur in Africa, according to the WHO. A surmounted 90% of these patients are from Africa, and as a consequence, 300 000 infants die annually as a result of poor care or difficulty accessing adequate healthcare. However, the high prevalence of CHDs, precipitated by a plethora of aetiologies worldwide, is particularly pronounced in Africa due to maternal infectious diseases like syphilis and rubella amongst the pregnant populace. In low- and middle-income countries, especially in Africa, where foreign missions and organizations care for the majority of complicated cardiac surgical patients, access to secure and affordable cardiac surgical therapy is a substantial issue. Interventions for CHDs are very expensive in Africa as many of the continent’s domiciles possess low expenditures and funding, thereby cannot afford the costs indicated by associated surgical treatments. Access to management and healthcare for CHDs is further hampered by a lack of trained surgical personnel, specialized tools, infrastructure, and diagnostic facilities in Africa.
Anxiety and depression amongst youth as adverse effects of using social media : A Review
Authors: Prasad Sakshi , Ait Souabni Sara , Anugwom Gibson , Aneni Kammarauche , Anand Ayush , Urhi Alexsandra , Obi-Azuike Crystal , Gibson Taneil , Khan Asma , Oladunjoye Funso
Published: August 2023

Background:

Social media use has become widely popularized in modern society and because of that, human interactions have drastically changed. In parallel, depression and anxiety have reached unprecedented levels among the youth, and concerns have emerged on social media use compromising mental health. The objectives of our review are to explore if there is a relation between social media and the development of those two disorders among youth, to highlight the patterns that could lead to them, and to give recommendations for future research.

Methods:

Based on the Scale for the Assessment of Narrative Review Articles (SANRA) Criteria, the authors performed a search of all-time articles published in the Medline database using terms such as social media, social media use, problematic social media use, depression, anxiety, suicidality, self-harm, fear of missing out, cyberchondria, cyberbullying, sexting, and online shopping. The initial search yielded 184 924 articles. After review, 77 articles were included for discussion.

Results:

Social media use is often associated with depression and anxiety. Different patterns are thought to predict poorer mental health outcomes like multitasking, emotional investment, appearance-based activities, passive media use, problematic social media use, cyberbullying, sexting, and disaster awareness.

Conclusion:

Specific patterns of engagement with social media appear to be associated with poor mental health outcomes in youth. It is important for physicians to address social networks exposure in well-visits and for parents to communicate about it openly. However, more in-depth research needs to be done to determine a relation of causality.
Re-emergence of monkeypox virus outbreak in Nigeria: epidemic preparedness and response (Review-Commentary)
Authors: Precious Nengak D. , Agboola Progress , Oluwatimilehin Oladapo , Olakunle Olawale K. , Olaniyi Peter , Adiatu Azeez I. , Olusogo Agboola P. , Obiwulu Danielle J. , Adeola Olowoyeye A. , Ebubechukwu Eze S. , Oluwakayode Adebayo M. , Akano Olatokun S. , Kolawole Queen O.
Published: August 2023

The re-emergence of the monkeypox virus has come with many burdens on nations. This is partly after the effects of the coronavirus disease 2019 virus is subsiding. The burden of the monkeypox virus is seen even more in developing and third-world countries. Beyond the monkeypox virus re-emergence, there have also been several other viruses within the world and in Nigeria. This study assessed Nigeria’s preparedness and response to the re-emergence of the monkeypox virus. The Nigerian Government showed its preparedness in the fight against the monkeypox virus by bringing together both Human and Animal Health Sectors. It ensured interventions and programs were created. Among these is Surveillance Outbreak, Response, Management, and Analysis System, a Surveillance and monitoring intervention to manage any outbreak. A second intervention is the Emergency Operation Center. It is recommended that vaccines should be made available, personnel should be adequately trained, and improved diagnostics equipment be made available. Nigeria has had cases of the monkeypox virus, and we wanted to see how far it has come in its preparedness and how it will respond if the need arises. This study reviewed existing literature on Nigeria’s battle against the monkeypox virus in times past, the actions taken, and the programs developed.
Semidorsal Preservation Techniques With Ostectomy for Narrowing the Nasal Roof
Authors: Öztürk Güncel
Published: August 2023

Dorsal hump deformity is prevalent in Caucasians because of their nasal structure. The dorsal preservation techniques became more popular in recent years. However, there is still not a clear solution for patients who have nasal hump deformity and a wide nasal roof. The present study aims defining a new technique that combines push-down or let-down procedures with ostectomy in patients who have nasal hump deformity and a wide nasal roof. In the present research, the records of patients were assessed retrospectively. The patients who had nasal hump deformity and who have undergone either push-down or let-down approaches were included. The push-down or let-down techniques used in this study involved ostectomy to reduce the nasal hump and narrow the nasal roof. The initial median Rhinoplasty Outcome Evaluation score before surgery was 57.5, which significantly improved to 93.00 points at 12 months after surgery (P<0.001). The study suggests that experienced surgeons using push-down and let-down techniques can achieve better esthetic results in patients with a wide nasal roof.
Older Adults With Inflammatory Bowel Disease in Canada
Authors: Rohatinsky Noelle , Chauhan Usha , Currie Barbara , Peacock Shelley , Phalen-Kelly Kelly , Russell Brooke , Tooke Natasha
Published: August 2023

Literature exploring the health-related quality of life and care experiences of older adults with inflammatory bowel disease is limited despite the increasing prevalence in this population. The purpose of this study was to explore the perceived health-related quality of life and care experiences in older adults with inflammatory bowel disease in Canada. This study used a mixed-methods convergent design consisting of a descriptive, cross-sectional survey and qualitative descriptive interviews. Fifty-eight participants completed the survey and 24 participants completed interviews. Older adults reported satisfaction with inflammatory bowel disease-related care, high levels of disease control, moderate health-related quality of life, and low levels of patient–healthcare team interactions. Themes identified were (1) Experiences of inflammatory bowel disease in daily life; (2) Accessibility of inflammatory bowel disease–related health services; and (3) Communication and relationships to facilitate inflammatory bowel disease care. Ultimately, quality inflammatory bowel disease care for older adults is contingent upon communication between patients and providers, access to multidisciplinary clinics, and support networks. By ensuring these factors are present, providers and patients can work together collectively toward positive patient outcomes, enhanced satisfaction with care, and greater perceived quality of care.
Utility of sTREM-1 biomarker and hcp Gene for Identification of Acinetobacter baumannii Colonization and Infection in Lung
Authors: Wang Xiaolei , Jiang Jiahui , Wei Chenxing , Yang Wenjie , Chen Jian , Dong Xueyan , Wan Haitong , Yu Daojun
Published: August 2023

Objective

Respiratory infections or colonization of Acinetobacter baumannii (Ab) are common in clinical practice but are treated differently. Early identification of Ab infection and colonization reduces the risk of antibiotic mismatch but objective laboratory indicators to distinguish between bacterial infections and colonization are lacking. To distinguish infection and colonization of Ab, we tested the role of two biomarkers, triggering receptor expressed on myeloid cells-1 (TREM-1) and Hemolysin co-regulated protein (Hcp).

Methods

A total of 96 inpatients with Ab were divided into infection and colonization groups. Blood samples were collected on day 1, 2, 3, 5, 8 and 10 and daily maximum body temperature (T) was recorded.PCR and RT-PCR were used to detect the presence and expression levels of the hcp gene in Ab clinical isolates.

Results

sTREM-1 and PCT levels on days 1-10 and neutrophil classification (N%) on days 1-3 were different (P < 0.05) in the infection group and colonization group.ROC curves showed significant differences in N% and sTREM-1 on days 2 and 3(P < 0.01).sTREM-1 had the highest AUCROC on days 1, 2 and 3 of all the markers. On day 1, the ROC curve of "WBC&N%&PCT&sTREM-1"was statistically different from individual indices (WBC count, N% and PCT; P < 0.05) and was equal to the ROC curve of sTREM-1 (P > 0.05). 35 of 96 patients were classified as infection group and 61 as colonization group with hcp gene detection rates of 71.43% (25/35) and 31.15% (19/61), respectively. No differences in hcp gene presence and transcript levels were found between two groups (P > 0.05).

Conclusion

Dynamic monitoring of sTREM-1 and PCT are valuable in identifying Ab infection and colonization. sTREM-1, can be improved by combination with multiple biomarkers in the early stage for identification of infection and colonization. The hcp gene was more likely to be present in the infection cohort.
Textbook Oncological Outcome in European Gastrodata
Authors: Sędłak Katarzyna , Rawicz-Pruszyński Karol , Mlak Radosław , Van Sandick Johanna , Gisbertz Suzanne , Pera Manuel , Dal Cero Mariagiulia , Baiocchi Gian Luca , Celotti Andrea , Morgagni Paolo , Vittimberga Giovani , Hoelscher Arnulf , Moenig Stefan , Kołodziejczyk Piotr , Richter Piotr , Gockel Ines , Piessen Guillaume , Da Costa Paulo Matos , Davies Andrew , Baker Cara , Allum William , Romario Uberto Fumagalli , De Pascale Stefano , Rosati Ricccardo , Reim Daniel , Santos Lucio Lara , D’ugo Domenico , Wijnhoven Bas , Degiuli Maurizio , De Manzoni Giovanni , Kielan Wojciech , Frejlich Ewelina , Schneider Paul , Polkowski Wojciech P.
Published: August 2023

Objective:

To assess the rate of textbook outcome (TO) and textbook oncological outcome (TOO) in European population based on Gastrodata registry.

Background:

TO is a composite parameter assessing surgical quality and strongly correlates with improved overall survival. Following the standard of treatment for locally advanced gastric cancer (GC), TOO was proposed as a quality and optimal multimodal treatment parameter.

Methods:

TO was achieved when all the following criteria were met: no intraoperative complications, radical resection according to the surgeon, pR0 resection, retrieval of at least 15 lymph nodes, no severe postoperative complications, no reintervention, no admission to the intensive care unit, no prolonged length of stay, no postoperative mortality and no hospital readmission. TOO was defined as TO with addition of perioperative chemotherapy compliance.

Results:

From the 2558 patients, 1700 were included in the analysis. TO was achieved in 1164 (68.5%) patients. The use of neoadjuvant chemotherapy (OR=1.33, 95%CI: 1.04-1.70) and D2 or D2+ lymphadenectomy (OR=1.55, 95%CI: 1.15-2.10) had a positive impact on TO achievement. Older age (OR=0.73, 95%CI: 0.54-0.94), pT3/4 (OR=0.79, 95%CI: 0.63-0.99), ASA 3/4 (OR=0.68, 95%CI: 0.54-0.86) and total gastrectomy (OR=0.56, 95%CI: 0.45-0.70), had negative impact on TO achievement. TOO was achieved in 388 (22.8%) patients. Older age (OR=0.37, 95%CI: 0.27-0.53), pT3-pT4 (OR=0.52, 95%CI: 0.39-0.69) and ASA 3-4 (OR=0.58, 95%CI: 95%CI: 0.43-0.79) had negative impact on TOO achievement.

Conclusion:

Despite successively improved surgical outcomes, stage‐appropriate chemotherapy in adherence to the current guidelines for multimodal treatment of GC remains poor. Further implementation of oncologic quality metrics should include greater emphasis on perioperative chemotherapy and adequate lymphadenectomy.
Treatment of high dose of intravenous midazolam abuse: a case report
Authors: Ramazani Yeganeh , Nemati Ahmad , Moshiri Mohammad , Talebi Mahdi , Dadkhah Mohammad , Etemad Leila
Published: August 2023

This study reports a rare case of high-dose midazolam abuse and Munchausen Syndrome. A 48-year-old female physician was referred by a psychiatrist to the Toxicology Department of Imam Reza Hospital for abstaining from 300 mg/day of parenteral midazolam. She had mimicked the symptoms of Crohn’s disease; therefore, she had undergone 15 colonoscopies and 40 times MRI or CT scan, all of which were normal. Six months earlier, she had switched oral methadone to 30 mg/day of intravenous midazolam. She also had several skin lesions on injection sites that she considered pyoderma gangrenosum. When the total daily dose of intravenous midazolam was switched to oral bioequivalence of clonazepam, she could not tolerate withdrawal (Clinical Institute Withdrawal Assessment Scale-Benzodiazepines = 68). Therefore, she received midazolam again as a continuous intravenous infusion. Within 7 days, the whole dose was replaced by the bioequivalence oral dose of clonazepam. She was also treated with carbamazepine and cognitive behavior therapy. Afterward, she was transferred to the psychiatric ward for further psychiatric treatment. Dependency on a high dose of midazolam could be treated by tapering off the long-acting benzodiazepine.
Towards the optimization of passive undulatory locomotion on land: mathematical and physical models
Authors: Yaqoob Basit , Dottore Emanuela Del , Mondini Alessio , Rodella Andrea , Mazzolai Barbara , Pugno Nicola M.
Published: August 2023

The current study investigates the body–environment interaction and exploits the passive viscoelastic properties of the body to perform undulatory locomotion. The investigations are carried out using a mathematical model based on a dry frictional environment, and the results are compared with the performance obtained using a physical model. The physical robot is a wheel-based modular system with flexible joints moving on different substrates. The influence of the spatial distribution of body stiffness on speed performance is also investigated. Our results suggest that the environment affects the performance of undulatory locomotion based on the distribution of body stiffness. While stiffness may vary with the environment, we have established a qualitative constitutive law that holds across environments. Specifically, we expect the stiffness distribution to exhibit either an ascending–descending or an ascending–plateau pattern along the length of the object, from head to tail. Furthermore, undulatory locomotion showed sensitivity to contact mechanics: solid–solid or solid–viscoelastic contact produced different locomotion kinematics. Our results elucidate how terrestrial limbless animals achieve undulatory locomotion performance by exploiting the passive properties of the environment and the body. Application of the results obtained may lead to better performing long-segmented robots that exploit the suitability of passive body dynamics and the properties of the environment in which they need to move.