bluuebunny/crossref_metadata_2025 huggingface dataset:
Serum Levels of Immunoglobulin Isotypes and Immunoglobulin G Subtypes in Healthy Term Turkish Newborns
Authors: Caner İ , Koca Erhan , Özdemir Öner
Published: August 2023

Aims:

We aimed to determine the normal immunoglobulin values of Turkish new-borns by studying IgG, IgA, IgM, and IgG subgroups (IgG1, IgG2, IgG3, and IgG4) from term, healthy neonates born in the Sakarya province of Turkey.

Subjects and Methods:

In our study, IgA, IgM, IgG, and IgG subgroup levels were measured nephelometrically in 54 new-borns (15–21-day-old). They were born between 39 and 41 weeks of gestation by problem-free delivery and with Apgar scores >8 at 1 and 5 minutes. The enrolled neonates were singletons and were free of congenital diseases/anomalies, history of perinatal infection, and with no known history of transfusion or chronic disease in the mother. The study findings were also evaluated in terms of differences based on delivery mode, feeding type, gender, and demographic characteristics.

Results:

This study enrolled 54 new-borns, 42 (77.8%) of whom were born by cesarean section and 12 (22.2%) by spontaneous vaginal delivery. Of the new-borns, 41 (75.9%) were only breastfed, and 13 (24.1%) were fed with combined breast milk and baby formula. The 95% confidence intervals of serum immunoglobulins and IgG subgroups were as follows: IgG, 652–722 mg/dL; IgA, 6–8 mg/dL; IgM, 27–35 mg/dL; IgG1, 495.7–544.3 mg/dL; IgG2, 139.6–169.5 mg/dL; IgG3, 22.7–27.7 mg/dL; and IgG4, 21.5–33.7 mg/dL. There was no significant correlation between any demographic characteristic and any immunoglobulin type. A low-moderate but significant negative correlation (r: –0.34) was found between birth length and IgA and a low-moderate but significant positive correlation (r: 0.32) was found between head circumference and IgM level.

Conclusion:

Our study provided usable data on the normal values of serum IgG, IgA, IgM, and IgG subgroups among healthy Turkish new-borns. This study is thought to be one of the most standardized and reliable reference sources for our country.
The Expression and Relationship of AdipoR1/R2 in Gastric Intestinal Metaplasia
Authors: Ayyildiz T , Dolar E , Ugras N , Dizdar OS , Erturk B , Adim SB , Yercı O
Published: August 2023

Background:

Adiponectin (ApN) is a 244-amino acid protein mainly secreted from the adipose tissue and involved in various physiological functions. ApN exerts its metabolic effects by binding to two major receptors: adiponectin receptor-1 (Adipo-R1) and adiponectin receptor-2 (Adipo-R2). Recent studies have reported ApN's involvement in the progression of cancer. However, there are no studies evaluating the relationship between Adipo-R1/R2 expression and gastric intestinal metaplasia (IM), which is a predisposing factor in gastric cancer (GC) development, and Helicobacter pylori H. pylori infection.

Aims:

In this study we aimed to investigate the relationship between the Adipo-R1/-R2 expression and H. pylori infection in patients with GC and gastric IM.

Materials and Methods:

Forty patients that underwent gastric resection and 56 patients that developed gastric IM were included in the study. The Adipo-R1/-R2 expression and the presence of H. pylori were examined immunohistochemically. The univariate analyses showed that the expression of Adipo-R1/-R2 in GC patients was significantly lower compared to both complete metaplasia (CM) and incomplete metaplasia (ICM) patients (p <0.0001 for both).

Results:

According to multiple multinomial logistic regression analysis, Adipo-R1/-R2 expression in the CM group was significantly higher than in the GC group (p = 0.05, p = 0.014, respectively). Moreover, Adipo-R1/-R2 expression was significantly higher in ICM group compared to the GC group (p=0.012, p=0.045, respectively). However, in both analyses no significant difference was determined in terms of H. pylori positivity between the groups.

Conclusion:

The resulting data suggests that ApN plays a role in GC processes via Adipo-R1/-R2 receptors.
Effects of Mouthwashes on Color Stability and Surface Roughness of Three Different Resin-based Composites
Authors: Çelik ACT , Çoban E , Ülker HE
Published: August 2023

Objective:

The aim of this study is to evaluate the effects of different types of mouthwashes (Klorhexidin, Curasept ADS 205, Meridol, Listerine Cool Citrus) on the surface roughness and color changes of a microhybrid (Point 4), a bulk fill (SonicFill), and a nanohybrid (Nova Compo-N) resin-based composite (RBC).

Materials and Methods:

Disk-shaped specimens were prepared from tested RBCs and divided into four subgroups which immersed in four different types of mouthwashes. The specimens were subjected to immersion cycles in the mouthwashes and artificial saliva (n = 8). Each cycle consisted of complete immersion in a mouthwash for 21 min and afterwards in saliva for 12 h at 37°C, and this cycle was repeated 8 times. The surface roughness was evaluated using a profilometer and coloration was evaluated using a spectrophotometer before and after immersion time. One-way analysis of variance (ANOVA) for the evaluation of surface roughness data was performed, and interrelation between groups was identified with the Sheffe's multiple comparison test.

Results:

There were no significant differences between the Ra values of the RBCs before and after immersion in mouthwashes (P > 0.05). There were significant differences between ΔE value of the SF and NCN groups before and after immersion time (P < 0.05).

Conclusion:

Mouthwashes contribute to oral health, especially in patients at high risk of caries. However, in such patients, patient-specific recommendations should be made when using mouthwashes due to the large number of composite fillings.
Awareness of Dental Practitioners and Intern Dental Practitioners in Northern Cyprus towards Pandemic of SARS-CoV-2
Authors: Önöral Ö , Caymaz MG
Published: August 2023

Aims:

This study aimed to evaluate the perception, attitude, and awareness of dental practitioners (DPs) and intern DPs towards SARS-COV-2 by comparing the awareness-attitude score (AAS).

Materials and Methods:

An online survey was generated in Google Forms. An invitation email was sent to all DPs in Northern Cyprus (n = 270) and intern DPs at Near East University (n = 200). Data were blindly collected from March 2020 to May 2020. Participants received 1 point for each correct answer. By adding up all collected points, an AAS was determined. Data were statistically analyzed.

Results:

The questionnaire was answered by 228 DPs (84% response-rate). No statistically significant difference was detected between gender-groups in terms of AAS (P = 0.301). A significant difference was detected between occupation groups in terms of AAS (P = 0.006), and of these, dentist-academician-group exhibited superior score. Other tested variables (specialty, way of occupation, place of occupation, and duration of occupation) had no influence on the AAS (P > 0.05). Relation between age and AAS was statistically significant (P = 0.054, Spearmen Correlation). Increasing age increases AAS as linear relation was detected between these variables (P = 0.011, Linear Regression). The questionnaire was also answered by 182 intern DPs (91% response-rate). No significant difference was detected between gender-groups (P = 0.378). Correlation was insignificant between age and AAS (P = 0.933).

Conclusions:

Occupation is the only variable influencing AAS of DPs. Academicians exhibited superior knowledge regarding SARS-CoV-2. The AASs of DPs and intern DPs were analogous.
Functional Outcome of Staged Reconstruction of Blast Injury of the Hand
Authors: Sabo VY
Published: August 2023

The purpose of this study is to describe the details of initial care, reconstruction and rehabilitation of blast injury to the hand of an adult scavenger staff of a recycling plant from an IED and determine the functional outcome of the treatment in terms of restoration of prehension of the hand. A detailed chronology of the clinical evaluation of a Nigerian adult admitted on the 14th of August, 2018 with blast injury to his left hand, the initial and subsequent care he received (while both on admission and after discharge) and the outcome of the treatment: return of prehension and time taken by patient to return to work. This patient was resuscitated and had initial care which comprised of serial debridement and fixation of fractures. Subsequent care he had included: wound resurfacing with thoraco-abdominal flap and glabrous skin grafting, digit stump refashioning of injured hand. Rehabilitation was achieved by meticulous physiotherapy and patient regained adequate prehensile function and returned to work within three months of discharge. Follow up at 16months showed tremendous improvement of function of the hand. A carefully executed care plan is rewarded with a good functional outcome (restoration of prehension of the injured hand and return to work) especially when treating a patient with a complex injury like blast injury to the hand.
Comparison of Airway Measurements in Rheumatoid Arthritis and Non-rheumatoid Patients using Lateral Cephalometric Radiographs
Authors: Badr FF , Jadu FM , Nasir AM , Jan AM , Wali S , Mustafa M , Bawazin Y , Meisha D
Published: August 2023

Objective:

The aim of this study was to investigate the potential relationship between the volumetric area of the upper airway and rheumatoid arthritis (RA) by comparing upper airway measurements between patients with and without RA.

Methods:

This case-control study compared upper airway measurements between patients with and without RA using lateral cephalometric radiographs. Two distinct measurements were made: the area of the upper airway, which is defined as “the area extending from the point of the retro-palatal region to the base of the epiglottis,” and the distance of the upper airway, which is defined as “the distance between the anterior border of the third cervical vertebra (C3) and the anterior border of the soft tissue of the neck“. A single examiner performed all measurements, and the intra-examiner reliability was assessed.

Results:

Sixty-one RA patients and 95 non-RA patients were included in the case and control groups, respectively. RA patients were significantly older in age and with higher BMI values. Patients with or without RA had Angle Class II as the most prevalent orthodontic classification. The upper airway was slightly narrower in RA patients, resulting in a smaller area, and the length of the upper airway was significantly longer in RA patients.

Conclusion:

Patients with RA have narrower upper airways as measured on lateral cephalometric radiographs. This may partially explain the high prevalence of obstructive sleep apnea among patients with RA. Focusing on airways measurements when cephalometric radiographs are taken for patients with RA could give some idea about which patient is likely to have OSA.
Knowledge, Attitudes, and Perceptions Related to Telemedicine among Young Doctors and Nursing Staff at the King Abdul-Aziz University Hospital Jeddah, KSA
Authors: Ahmed TJ , Baig M , Bashir MA , Gazzaz ZJ , Butt NS , Khan SA
Published: August 2023

Objective:

To investigate the knowledge, perceptions, and attitude of young doctors and nurses at Kind Abdulaziz University Hospital (KAUH) Jeddah, KSA, regarding the effectiveness of telemedicine in dealing with the patients for either follow-up or continuous monitoring of chronic diseases.

Material and Methods:

This prospective cross-sectional study was carried out on the young doctors and nursing staff at KAUH. An online questionnaire addressing all the required fields, i.e., background essential demography, perceptions, acceptance, and knowledge regarding telemedicine's utility, was sent to the targeted population of health care workers. Completed responses were analyzed statistically as per study objectives.

Results:

The response rate in our study was 85%. A total of 335 participants responded to our questionnaire. One hundred seventy-one (51.1%) were doctors, whereas one hundred sixty-four (48.9%) were the nursing staff. Among doctors, 50 (29.4%) were recent graduates, whereas, in the nursing side, 77 (46.7%) were the senior nursing students. The knowledge and attitude of the young nursing staff were relatively better than the senior staff taking part in the study and the trends were found statistically significant.

Conclusion:

Our study participants, being young, were enthusiastic, had good knowledge regarding the advantages and limitations of telemedicine in managing the selected groups of patients. Their perception and attitude were quite positive. This is an encouraging trend in the promotion of telemedicine as an established way of managing patients with special requirements in an effective way. The ongoing COVID-19 pandemic has highlighted the importance of telemedicine in emergencies to protect both patients and health care workers by reducing chronic patients' avoidable hospital visits.
Implementing Trauma Resuscitation Protocol in COVID 19 Era
Authors: Okoye OG
Published: August 2023

Trauma remains the leading cause of death in individuals less than 45 years. Management of major trauma is protocol driven around the world. Most protocols are in line with the popular Advanced Trauma Life Support (ATLS) principles. These principles have been adjudged to be safe and consistent even in the presence of infectious diseases while employing standard precautions. In view of the current community spread, large cases of COVID 19 in the Federal Capital Territory (FCT) and the magnitude of the infectivity, it has become necessary to adjust our local trauma resuscitation protocols in order to ensure the safety of the trauma team and the trauma patients as well.
Abnormal Blood Glucose and the Relationship with Clinical Outcome in Acutely Ill Children Admitted to the Emergency Unit of a Nigerian Tertiary Hospital
Authors: Ugege MO , Chikani UN , Yusuf T , Amodu-Sanni M , Ibitoye PK , Abdul Rahman MB
Published: August 2023

Background:

Dysglycemia (hyper- or hypoglycemia) is frequently seen in acutely ill children and may be associated with poor outcome.

Objective:

To determine and compare clinical characteristics and outcomes of children admitted for acute illnesses presenting with euglycemia and dysglycemia. A prospective cohort study was conducted in Emergency Pediatric Unit (EPU), of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto.

Subjects and Methods:

Children aged ≤15 years, admitted for acute illnesses were enrolled consecutively for a 6-month period. An Accu-Chek Active glucometer was used to check blood glucose of subjects at admission, and based on the result; subjects were categorized as either euglycemic or dysglycemic. The clinical characteristics and outcomes (discharged or died) were compared in the two groups. Statistical analysis involved Chi square test and logistic regression.

Results:

The median age of 376 subjects was 24 months (range: 1-156 months). Forty-four subjects (11.7%) had dysglycemia, consisting of 36 (9.6%) with hyperglycemia, and 8 (2.1%) with hypoglycemia, whereas 332 (88.3%) had euglycemia. The clinical characteristics associated with hyperglycemia were presence of fever (p = 0.001), and convulsion (p = 0.04), whereas hypoglycemia; coma and hepatomegaly (p = 0.01). Forty subjects (40/376, 10.6%) died. The proportion of those that died in the dysglycemic group (10/44, 22.7%) was significantly higher than that in the euglycemic group (30/332, 9%) (p = 0.006). Subjects who had hyperglycemia were 2.6 times less likely to survive (OR = 2.64, 95% CI: 1.02--6.79, P = 0.05) compared to their euglycemic counterparts. Hypoglycemia was not significantly associated with death outcome (p = 0.13).

Conclusion:

Dysglycemia, particularly hyperglycemia, was significantly associated with increased mortality in acutely ill children. We recommend routine bedside glucose estimation for all acutely ill children at admission to the emergency unit, to detect dysglycemia, treat hypoglycemia promptly, monitor closely, and treat aggressively the underlying conditions in children with hyperglycemia to prevent attendant high mortality.
Study of Aqueous Ecballium Elaterium as Fibrinolytic in The Rabbit Model of Intrapleural Empyema
Authors: Şahin A , Oruc M , Meteroğlu F , Erbey A , Alabalık U , Kaplan İ
Published: August 2023

Aims:

We aimed to investigate of intrapleural use of ecballium elaterium (EE) in a rabbit model empyema.

Methods:

An empyema was induced in 21 rabbits after inoculation of Staphylococcus aureus. Glucose levels, pH, lactate dehydrogenase levels, and amounts of pleural drainage were evaluated in addition to pleural and empyema scores. The rabbits were divided into three groups, each 7, the isotonic solution, the streptokinase, and the ecballium group.

Results:

At autopsy, there was no difference in pH, glucose, and LDH levels in three groups. The mean pleural drainage was greater in the ecballium group. A significant difference was detected between groups in terms of drainage amounts and pleural and empyema scores (P < 0.05). A significant difference in pleural and empyema scores was detected in the ecballium and streptokinase groups (P < 0.05). EE group had significant differences in drainage amounts and plural and empyema scores regard to the control group (P < 0.05). No significance was found between streptokinase and EE groups.

Conclusion:

We conclude that intrapleural use of EE is at least as effective as streptokinase for the treatment of empyema.
Evaluating the Effect of Subcrestal Placement on Platform Switched Short Dental Implants and Von Mises Stress in D3 Bone–A 3D FEM Study
Authors: Reddy MS , Rajasekar S , Eid Abdelmagyd HA
Published: August 2023

Aim:

To investigate the effect of platform switched short dental implants and subcrestal placement on von Mises stress in the maxillary anterior region (D3 bone) by using three-dimensional finite element model analyses (3D FEM).

Materials and Methods:

Biomechanical behaviour of von Mises stress in maxillary anterior region (D3) bone were stimulated with the help of 3D FEM with the help of ANSYS WORKBENCH version 17.5. The bone model had a cortical core of (1 mm) surrounding the inner cancellous core, which represents D3 bone. Two models were designed model 1 (6 x 4.6 mm), (7.5 x 4.6 mm) and model 2 (6 x 5.8 mm), (7.5 x 5.8 mm). Loads of 100, 200 N were applied at an angle of 0°, 15°, 30° along the long axis of the tooth model.

Results:

In all model's cortical bone exhibited greater stress than cancellous bone. Greater stress was reported in axial direction at 30° then 15° and least at 0° irrespective of load applied. An increase in implant length (7.5 mm) did not exhibit any stress reduction in both the model but implant diameter (5.8 mm) led to reduction in von Mises stress in both the groups. Greater the force applied greater was stress in both bones irrespective of direction of force applied (200N). Lastly subcrestal (0.5 mm) placement has slight reduction in stress compared to equicrestal placement in both the groups.

Conclusion:

Numerical results from the current study suggest that, for short implants, implant diameter is considered more effective design parameter than implant length. Current findings state that platform switch short subcrestal implants results in conservation of marginal bone loss along with better stress distribution around peri-implant regions in D3 bone. However, all models analyzed in this study showed development of von Mesies stresses within physiological limits for human cortical bone.
Assessment of Visceral and Subcutaneous Obesity to Understand the Efficiency of Adipose Tissue in Acute Pancreatitis
Authors: Dal MB , Ulutas KT
Published: August 2023

Background:

Fat accumulation in the visceral and subcutaneous regions can trigger fat necrosis during acute pancreatitis (AP).

Aims:

We investigated the role of visceral and subcutaneous fat in acute pancreatitis. In this study, we investigated the role of visceral and subcutaneous fat to understand the efficiency of adipose tissue in the AP.

Materials and Methods:

Computed tomography of 68 patients and 68 healthy at the level of L4-5 intervertebral disc were analyzed for body adiposity composition using designated software. Body subcutaneous and visceral composition was measured by using the designated software of the CT.

Results:

Visceral fat was higher in the control group (198 ± 146) than the group of the AP (155 ± 118) (P = 0.038), whereas the subcutaneous fat was found higher in the AP instead (292 ± 133 to 139 ± 102; P = 0,001). Visceral fat (B = 0,29; P = 0,0013), gender (male) (B = -0.3; P = 0.0122), age (B = 0.274; P = 0.0087), and complication (B = -0.229; P = 0.007) predicted the subcutaneous fat as the dependent variable. In the receiver operating characteristic (ROC), the area under curve was 0.562 (0.402–0.636; 95% CI, P = 0.038) for the visceral fat, while it was 0.906 (0.824–0.962; 95% CI, P < 0.0001) for the subcutaneous fat. Its cutoff was calculated as 183.7 for subcutaneous fat.

Conclusion:

Visceral fat analysis showed a contradiction according to subcutaneous fat that AP was strongly associated with subcutaneous one. The result supports that visceral and subcutaneous fat tissues should have different path of inflammation affecting the AP.
Oxidative Stress Parameters and Antioxidant Enzyme Levels in Patients with Central Serous Chorioretinopathy
Authors: Urfalioglu S , Baylan F Alkan , Güler M
Published: August 2023

Background:

Central serous chorioretinopathy (CSC) is a posterior segment disease caused by macular serous detachment as a result of inflammation and oxidative stress due to hypoperfusion of choriocapillaris.

Aims:

The aim of the study was to assess the oxidant/antioxidant balance in CSC.s

Materials and Methods:

The plasma levels of malonyl dialdehyde (MDA), glutathione peroxidase (GSH-Px), myeloperoxidase (MPO), catalase (CAT), and xanthine oxidase (XO) were assessed in 21 patients with CSC (group S) and in 23 individuals without any eye pathology as the control group (group C). Furthermore, the disease was staged through routine opthalmologic examination as well as optic coherence tomography (OCT).

Results:

MDA levels were significantly higher in group S (25.36 ± 4.51 nmol/ml), when compared with group C (22.79 ± 3.23 nmol/ml) (P = 0.035). In addition, the levels of CAT were significantly lower in group S (8.28 ± 5.85 U/ml) when compared to group C (14.02 ± 8.61 (P = 0.014).

Conclusion:

Prevention of the oxidative injury may be considered among the associated treatment options under the light of the changes detected in the oxidative/antioxidative parameters.
Risk Factors for Maternal and Perinatal Complications during Pregnancy among Women with Tetralogy of Fallot
Authors: Huang TT , Zhao WX , Lin JH
Published: August 2023

Background:

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease during pregnancy. Studies of risk factors are of great significance to maternal and fetal outcomes in patients with TOF.

Aims:

To identify predictive risk factors for maternal and perinatal complications in women with TOF.

Subjects and Methods:

78 patients with TOF who delivered at Shanghai Obstetrical Cardiology Intensive Care Center between January 1993 and December 2017 were retrospective reviewed. A logistic regression model was used to identify risk factors for maternal and perinatal complications.

Results:

There was no maternal death, five patients developed cardiac failure, sustained arrhythmias requiring treatments were recorded among 2 patients. Factors identified for maternal complications included previous cardiac events and oxygen saturation <90%. Oxygen saturation <90% was found to be independent predictor of maternal cardiac complications (RR = 21.455, 95%CI 2.186–210.572, P = 0.009). The perinatal survival rate was 87.18%, there were 52 term deliveries (66.67%). Perinatal poor outcomes include 9 therapeutic abortions (11.54%), 1 neonatal death (1.28%), 16 premature births (20.51%), 18 small for gestational age children (23.08%), 3 neonatal asphyxia (3.85%), and 3 neonatal cardiac malformations (3.85%). Factors identified for perinatal complications included without cardiac surgery, higher hemoglobin values, higher hematocrit values, oxygen saturation <90%, right ventricular hypertrophy, pulmonary stenosis, ventricular septal defect, and pulmonary hypertension. Oxygen saturation <90% was found to be independent predictor of perinatal complications (RR = 8.270, 95%CI 1.374–49.790, P = 0.021).

Conclusions:

Oxygen saturation <90% is associated with maternal and perinatal risks. Women with TOF whose oxygen saturation <90% are not recommended for pregnancy because of high maternal and perinatal complications.
Coping Strategies among Patients Attending HIV Clinics in a North-central State of Nigeria
Authors: Ahmed A , Osinubi MO , Fasiku MM , Uthman MM , Soyannwo T , Jimoh OS
Published: August 2023

Background:

Nigeria ranks third among the countries with the highest HIV/AIDS burden in the world, next only to India and South Africa. The North-Central zone which Kwara State belongs to has the highest concentration of HIV prevalence rate of 7.5%, while the North-Western zone recorded the lowest prevalence of 2.1%; Kwara state has a prevalence rate of 2.2%.

Aims:

The study assessed the coping strategies adopted by patients attending HIV clinics in a North-central city of Nigeria.

Methods:

The study design was descriptive cross-sectional involving 384 HIV-positive patients who were systematically recruited at 5 public service delivery sites in Ilorin- a North-central city, Nigeria was used for the study. Coping strategies were measured using the Brief COPE scale. Data were analyzed using SPSS software version 20.0. Level of significance was pre-determined at P value <0.05 at a confidence level of 95%.

Results:

Female respondents constituted 222 (58.0%) while males were 162 (42.0%). Respondents experienced varying proportion of coping strategies of which Self-distraction 288 (75.0%), active coping 249 (64.8%), emotional support 228 (59.4%), among others were the major strategies adopted by respondents.

Conclusion:

HIV is a chronic disease with heavy burden on both patients and health facility rendering services for the care of these patients. A good proportion of respondents interviewed adopted varying coping strategies. Sustained social and psychological support will improve further the coping strategies of living with HIV.
Tibia Gap Nonunion Following Sequestrectomy Treated with a Nonvascularized Fibula Strut Graft
Authors: Onuoha KM , Bassey AO , Omotola O , Adedapo A
Published: August 2023

Chronic osteomyelitis of the tibia is a common sequela of acute osteomyelitis which may present with a bone defect following sequestrectomy. Treatment of the gap nonunion can be done with the ipsilateral fibula as a strut graft when harvested subperiosteally and this leads to good outcome. A 7-year-old girl presented to our facility with a 25 cm defect of her right tibia following sequestrectomy for chronic osteomyelitis in another facility. X-rays revealed a healthy tibia superiorly and inferiorly with an intact fibula. She subsequently had an ipsilateral subperiosteal nonvascularized fibula harvest which was used to fill the tibia defect as a strut graft. The synostosis healed perfectly and the fibula reossified, time to union was 17 weeks, and the patient commenced full weight-bearing thereafter. Management of bone gap following sequestrectomy for chronic osteomyelitis remains a challenge to the orthopedic surgeon. The subperiosteal fibular harvest and use as a strut graft is a viable option with good outcomes. Our experience with this case may serve as a way out of this usual challenge.
Role of Orff Music Therapy in Improving Auditory Processing Skills in Children with Intellectual Disability
Authors: Senkal OA , Muhtar Z
Published: August 2023

Background:

Orff Music Therapy improves auditory processing, language, and cognitive functions in children who have Intellectual Disability (ID).

Aims:

In literature, there are no studies from the auditory processing skills reviewing perspective. The current study examined the role of Orff Music Therapy in terms of auditory processing skills of children who have ID.

Method:

Twenty-nine children who have ID were subjected in a 6-week Orff Music Therapy program.

Results:

The mean musical assessment scores improved after Orff Music Therapy. The total Listening Inventory (TLI) scores before Orff Music Therapy were considered to be risky above the cut-off level for children who have ID. The criterion cutoff scores show if the child's behaviors may indicate a disorder or dysfunction. The TLI scores were reduced after Orff Music Therapy, which means there was an improvement in auditory processing skills.

Conclusion:

Auditory processing skills are essential for children who have ID. If a child who has ID has been identified as having auditory processing disorder (APD), there is a need for a proven therapeutic approach, like Orff Music Therapy. It has been considered that ID and APD can be linked in the same category of neurodevelopmental disorders.
Early Endoscopy Decrease the Length of Hospital Stay and the Costs in Patients with Upper Gastrointestinal Bleeding
Authors: Arslan E , Ozakin E , Temel T , Ozakyol AH , Acar N , Kaya FB , Canakci ME , Çağlayan T
Published: August 2023

Background:

Acute gastrointestinal (GI) bleeding is a common cause of hospitalization. There are conflicting results regarding the effectiveness of early endoscopy in patients with upper GI bleeding.

Objective:

The study aimed to determine the benefit of early endoscopy and the epidemiological characteristics of patients presenting to the emergency department with non-variceal acute upper GI bleeding.

Methods:

Patients over 18 years of age who presented to the emergency department with upper GI between 2015 and 2016 and underwent endoscopy were included in the study. The patients were divided into two groups: early endoscopy group (endoscopy within the 24 h) and late endoscopy group (endoscopy after 24 h).

Results:

Of 104 patients, 57.7% were man, and the mean age was 66.27 ± 17.64 years. Of the patients who underwent endoscopy, 80 (76.9%) were in the early endoscopy group. There was no difference in blood transfusion needs (P = 0.388), re-bleeding (P = 0.137), the need for surgery, and mortality rates with regard to the timing of endoscopy. The results of the receiver-operating characteristics curve analysis revealed patients with a GBS ≥ 9 were taken as high-risk, and a prognosis analysis was performed accordingly. However, in patients undergoing early endoscopy, a difference was detected with respect to the length of hospital stay (P = 0.011) and treatment costs (P = 0.030). In the comparison with the admission time (working/non-working h) and variables, there were no significant differences in the length of hospital stay (P = 0.230), transfusion needs (P = 0.348), re-bleeding frequency (P = 0.905), and treatment costs (P = 0.094).

Conclusion:

Endoscopy within 24 h in the setting of acute upper non-variceal GI bleeding is associated with an increase in the length of hospital stay and treatment costs, but is not associated with re-bleeding, transfusion needs, need for surgery, and mortality.
Trends and Burden of Hepatitis B Viral Infection in Children and Adults in a Tertiary Health Facility in North East Nigeria Over a Fifteen-year Period
Authors: Isaac WE , Jalo I , Ajani A , Oyeniyi CO , Abubakar JD , Aremu JT , Danlami MH
Published: August 2023

Background:

Hepatitis B infection is endemic in Nigeria where greater than six percent of the general population are chronic carriers. Transmission predominantly occurs in infants and children when compared with adults. Viral hepatitis deaths are mostly due to chronic liver disease. Routine immunization against hepatitis B virus infection in Nigeria is still low.

Aims:

We planned to describe the burden and trend of hepatitis B viral infection at Federal Teaching Hospital, Gombe.

Methodology:

This study was a retrospective cross-sectional descriptive study. The results of all hepatitis B surface antigen (HBsAg) tests using rapid chromatographic immunoassay performed at the Federal Teaching Hospital, Gombe (FTHG), Nigeria from January 2000 to December 2014 were retrieved and analyzed.

Results:

Between 2000 and 2014, 23,611 individuals ranging from 2 months to 98 years of age were tested for HBsAg. A total of 13,136 (55.6%) were males and 10,475 (44.4%) were females. Among individuals tested for hepatitis B surface antigen, 18.9% (4,456) were positive. A total of 70.6% (3,147) were males and 29.4% (11,239) were females. Male sex was significantly associated with HBsAg positivity (P < 0.001). The mean HBsAg prevalence over the 15-year periods among males and females were 22% and 12%, respectively (P < 0.001). The mean yearly HBV prevalence was 17.5%, 17.2%, 19.6%, 15.5%, and 4.4% among age-groups 0–18 years, 19–25 years, 26–45 years, 56–65 years, and >65 years, respectively (P = 0.132). The proportion of HBsAg-positive individuals was highest in the year 2012 (28.7%) and lowest in 2014 (1.8%).

Conclusion:

There was an increasing trend in HBV testing and diagnosis in children and adults in our facility over the last 15 years. Health facility capacity for HBV treatment and care requires strengthening
Coronary Artery Bypass Surgery without Blood Transfusion; is it Possible?
Authors: Aykut K , Albayrak G , Cetin Y , Ciftci N , Ciftci S
Published: August 2023

Background:

Coronary artery bypass surgery is the most commonly performed cardiac operation and approximately 40-70% of patients require a blood transfusion despite improvements in cardiac surgical techniques. Some preventive perfusion methods to avoid transfusions are described, such as acute normovolemic hemodilution, retrograde autologous priming, and usage of integrated arterial filter oxygenator.

Aims:

We combined these three techniques (triple combination technique) to evaluate whether it is possible to avoid blood transfusions in adult patients undergoing coronary artery bypass surgery.

Materials and Methods:

A total of 300 consecutive patients were included in this randomized controlled trial. 150 patients (Group 1) were operated with triple combination technique, The other 150 patients (Group 2) were operated with standard cardiopulmonary bypass technique. The two groups were compared in terms of peroperative and postoperative blood product use.

Results:

Ninety-two percent (92%) of the patients (Group 1) undergoing coronary artery bypass surgery did not require any blood transfusion. Only 8% of the patients required erythrocyte suspension or fresh frozen plasma transfusion. In Group 2, 58% of patients required blood transfusions. The difference between two groups was statistically significant (p < 0,05).

Conclusion:

Triple combination technique is safe and cost-effective in coronary artery bypass surgery. We think that most of the patients could be operated without blood transfusion with this technique.
The Impact of Infertility on the Sexual Life of Infertile Women in Enugu, South East Nigeria
Authors: Ndubuisi VA , Ezugwu EC , Chigbu CO , Ekwuazi KE , Onwuka CI
Published: August 2023

Background:

Infertility is a common gynecological problem in sub-Saharan Africa, including Nigeria. It tends to affect the sexual life of couples and may affect their quality of life.

Objective:

The study was aimed to assess the impact of infertility on the sexual life of women with infertility seeking care in Enugu, South-East Nigeria.

Methods:

A questionnaire-based, multicenter cross-sectional study of women with infertility managed at the Gynecology units of the two government-owned tertiary hospitals in Enugu over a 2 months period. The relevant data were obtained and analyzed using SPSS version 20.0.

Results:

Three hundred and sixty female respondents participated in the study. Their mean age was 35.23 ± 5.7 years. The majority of them were married (98.3%) and attained a tertiary level of education (69%). The number of respondents that reported adequate sexual intercourse dropped from 33.9% before the diagnosis of infertility to 12.2% after the diagnosis. Almost two-thirds of the respondents (65%) reported that they no longer enjoy sex with their husband/partner, whereas 38.9% of them feel they were no longer attracted to their partners.

Conclusion:

Infertility seems to have a negative effect on the sexual life of women. Addressing this identified negative effect may improve the outcome of infertility management and also may improve the quality of life of women with infertility in the region.
Generalized Eruptive Syringoma in a Nigerian Woman
Authors: Yahya H
Published: August 2023

Generalized eruptive syringomas are a very rare variant of syringoma which appear on the chest, neck, abdomen, upper and lower arms, thighs, legs and back. They often affect adolescent or post-adolescent females, although cases have been described in children and older adults. Generalized eruptive syringomas are mostly sporadic but familial cases, and those associated with eczematous skin conditions, solid organ transplants, renal cell carcinoma and some genodermatoses have also been reported. Although eruptive syringomas may resemble cutaneous mastocytosis, disseminated granuloma annulare, eruptive xanthomata, steatocystoma multiplex, eruptive velus hair syndrome, verruca plana and other skin conditions clinically, the histological appearance characterized by upper dermal epithelial cords with a tendency to ductule formation and tadpole extension of outer epithelial layer is diagnostic. We report the case of a 20-year-old Nigerian woman with generalized eruptive syringoma.
Changing Susceptibility Pattern of Neisseria Gonorrhoeae
Authors: Jimoh O , Aliyu S , Ejembi J , Abdulaziz MM , Ibrahim M , Ibrahim A , Olayinka AT
Published: August 2023

Gonorrhoea is a sexually transmitted infection (STI) that increases the risk of infection with human immunodeficiency virus (HIV) and causes infertility and urethral stricture. We describe three cases of sexually active men, otherwise stable, who presented with a history of painful micturition and creamy white, urethral discharge. A clinical diagnosis of gonococcal urethritis was made and confirmed by microscopy, culture and 16SrRNA. Antimicrobial susceptibility revealed resistance to all the antimicrobial agents tested including ceftriaxone. A dual therapy was initiated using ceftriaxone and azithromycin, but at a higher dose for the patient with multi-drug resistant (MDR) Neisseria gonorrhoeae. Patients did well and were followed up for 5 months. Contact tracing was done for their sexual partners. While it is also important for healthcare workers to familiarize themselves with current treatment guidelines for gonococcal urethritis, the place of clinical laboratory in the management of STIs, with molecular techniques and the need for surveillance for MDR Neisseria gonorrhoeae cannot be overemphasized.
Nitric Oxide in Infertile Females in the Niger-Delta Region of Nigeria
Authors: Okhionkpamwonyi O , Okonta PI , Okoacha I , Idogun S
Published: August 2023

Background:

Infertility is a public health challenge and it is a distressing personal tragedy for couples, more so for the female partners. Risk factors and causes of infertility vary from region to region. Reactive species is of current interest in the pathogenesis and management of infertility, especially in the Niger-Delta Region of Nigeria where environmental hazards of oil exploration exists.

Aim:

The overall goal of this study was to determine and compare the serum reactive species levels (nitric oxide) in fertile and infertile women attending the infertility clinic at the Delta State University Teaching Hospital, Oghara, and Central Hospital, Warri.

Methods:

This was a prospective case-control study in which 70 women evaluated for infertility were recruited into the study. A fertile patient matched for age and body mass index (BMI) attending family planning clinic was selected as control. Serum nitric oxide estimation was done using the BioVision Nitric Oxide Colorimetric Assay Kit. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS). Student's t-test was applied to compare the serum levels of nitric acid and the differences were considered significant if P < 0.05.

Results:

Infertile women had significantly higher mean serum nitric oxide levels than fertile women: 34.33 (SD 5.93) μmol/L versus 18.27 (SD 2.63) μmol/L (P < 0.001). Women with secondary infertility had significantly higher mean levels of nitric oxide than those with primary infertility: 38.13 (SD 3.39) μmol/L versus 22.72 (SD 4.36) μmol/L (P < 0.001).

Conclusion:

The study showed that serum nitric oxide level was significantly elevated in women with infertility compared to women of proven fertility. Hence, oxidative stress from reactive species may be a contributory factor to infertility in women in the Niger-Delta Region of Nigeria.
Health-Related Quality of Life in Children and Adolescents with Epilepsy in Enugu
Authors: Aronu AE , Uwaezuoke N , Chinawa JM , Bisi-Onyemaechi A , Ojinnaka NC
Published: August 2023

Background:

Epilepsy, a chronic brain disorder, predisposes children to low Health-Related Quality of Life (HRQOL).

Objective:

This study aimed at assessing the HRQOL in Nigerian children with epilepsy and compare it with that in healthy children.

Methods:

A cross-sectional study of 166 children with epilepsy (CWE), aged 5–18 years on anti-epileptic drugs (AEDs) for at least 6 months and 166 age and sex–matched apparently healthy children was conducted. A generic version of the Pediatric Quality of Life (Peds QoL version 4) scale was used to assess HRQOL.

Results:

There were significant differences in Quality-of-Life mean scores in the domains of social functioning, psychosocial combination, and psychosocial plus physical activities between cases and controls. The school function scores of <50, indicating low QOL, were significantly more (Chi square = 35.37) (P = 0.0001) among the cases (32.5%) compared to the controls (6.3%). Similarly, low quality of life in the psychosocial combination were observed significantly (P_ = 0.042) more among the cases (12.7%) compared to the controls (6.3%). Low quality of life in emotional feeling domain were noted significantly (Chi square = 12.9) (P = 0.0002) more in subjects aged between 8 and 12 (20%). QOL scores of below 50 in the social function domain were observed significantly (Chi square = 6.49) (P = 0.039) more in subjects aged between 5 and 7 years (44.8%). There was significant gender difference in Quality-of-life index in school functioning domain in subjects. (Chi Square = 6.49) (P value = 0.039). Children in the upper social class scored higher in the social functioning domain, and social class was significantly associated with scores in the social domain of functioning. (F = 3.75 and P = 0.03). QOL scores below 50 in the emotional domain were significantly more among subjects aged 8–12 years/13–18 year, s and QOL scores of <50 in the school function domain were significantly more in subjects aged 5–7 years. (P = 0.0002) (P = 0.039), respectively.

Conclusion:

HRQOL is reduced in CWE in all domains of Peds QoL. Significant predictors of reduced HRQOL include age, gender, and socioeconomic class. Beyond seizure control, epilepsy management should be oriented towards ensuring the optimal health-related quality of life.
Comparison of the Treatment Outcomes of the Conventional Stainless Steel Crown Restorations and the Hall Technique in the Treatment of Carious Primary Molars
Authors: Ayedun OS , Oredugba FA , Sote EO
Published: August 2023

Background:

Dental caries is a multifactorial disease that causes reversible decalcification and cavitation of susceptible teeth exposed to sugary substrates over a period of time in the oral cavity. It gives clinical and social burdens to the child patients and their parents/carers. Stainless steel crown (SSC) restoration is one of the restorative treatment options in the management of carious primary molars.

Aims:

The Hall technique is a biologic method of managing primary teeth by sealing in the caries with preformed metal crowns (SSCs). The objectives of this study were to assess and compare the primary and secondary treatment outcomes of stainless steel crown restorations using the conventional method and the Hall technique in primary molars immediately after placement and over a 12-month period using both clinical and radiological parameters.

Methods:

The study was a randomized control clinical trial using a split mouth approach. A total of 25 stainless steel crown restorations using the conventional method and 25 stainless steel crown restorations using the Hall technique were placed in 25 subjects aged 3–8 years with a pair or pairs of unrestored enamel or dentinal carious primary molars matched for tooth type, dental arch, and extent of caries. All subjects were monitored and reviewed every 3 months for 12 months.

Results:

Twenty three subjects returned for follow-up. There was no statistically significant difference (P-value > 0.05) between the conventional SSC restoration and the Hall technique for both the primary outcomes/major failures (irreversible pulpitis, dental abscess, peri-radicular radiolucency, and crown loss with tooth unrestorable) and secondary outcomes/minor failures (crown loss and tooth restorable, crown perforation, secondary/marginal caries, and reversible pulpitis). But, there was a statistical significant difference in the average time taken for the placement of the restorations between the two groups (P-value 0.001).

Conclusion:

Both the conventional SSC restorations and the Hall technique can be provided for all the subjects in this study. The Hall Technique compared favorably well with the conventional SSC restoration in clinical and radiological outcomes. The Hall Technique appears to offer an effective treatment option for managing dental caries in primary molar teeth especially in a resource challenged environment where electricity and treatment under general aaesthesia can sometimes be a problem.
Prevalence and Risk Factors for Hepatitis B and C Among End-stage Renal Disease Patients on Hemodialysis in Gaborone, Botswana
Authors: Mahupe P , Molefe-Baikai OJ , Saleshando G , Rwegerera GM
Published: August 2023

Background:

Patients on maintenance hemodialysis (HD) are at risk of blood transmitted infections such as hepatitis B and C.

Objectives:

To determine the prevalence and risk factors for hepatitis B and hepatitis C virus infections among end-stage renal disease (ESRD) patients on maintenance hemodialysis in Gaborone, Botswana.

Materials and Methods:

A cross-sectional study with a retrospective longitudinal approach involving all eligible public patients undergoing hemodialysis was carried out for a period of 3 months. Data on socio-demographic, clinical characteristics, and hepatitis serology was collected using a case report form. Statistical Software Package for Social Sciences (SPSS) version 24 was used for data entry, cleaning, and analysis. The risk factors associated with Hepatitis B and C infections were determined using bivariate logistic regression analyses. A P value of less than 0.05 was considered statistically significant.

Results:

Of the 168 participants, 5 (2.98%) were HBsAg seropositive at the initiation of hemodialysis, whereas 2 (1.19%) were seropositive for anti-HCV antibodies at the initiation of hemodialysis. Two patients out of 163 (1.23%) were found to have seroconverted to HBsAg positivity during hemodialysis. One out of 166 patients (0.61%) seroconverted to HCV antibodies positivity during hemodialysis. The duration of hemodialysis, history of invasive procedures, HIV status, frequency of hospitalization, and blood transfusion were not associated with seroconversion for both Hepatitis B and C.

Conclusions:

The prevalence hepatitis B and C infections among ESRD patients on hemodialysis is low. There was no significant association between the identified risk factors and HBV/HCV infection. Regular audits on seroconversion status for hepatitis B and C are recommended as a way of assessing and supporting the current strategies for infection control among HD patients.