bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of left ventricular function in stable chronic obstructive pulmonary disease patients
Authors: Saha Kaushik , Sarkar Supriya , Mallik Jayanta Kumar , Ganguly Kajal , Saha Tushar Kanti , Maji Arnab
Published: May 2024

Background: Patients with chronic obstructive pulmonary disease (COPD) may have left ventricular (LV) dysfunction, even in the absence of known LV diseases. Aims: The aim of this study was to assess LV function in stable COPD patients. Setting and Design: This is a cross-sectional observational analytical study. Materials and Methods: We enrolled 300 stable COPD patients without any apparent LV disease (excluded by clinical examination, chest X-ray [CXR], and electrocardiography [ECG]). The control group consisted of 100 age- and sex-matched healthy subjects. LV systolic function was assessed using echocardiography by measuring shortening fraction (FS%), LV ejection fraction (EF%), and the mitral valve peak annular velocity at the LV lateral wall (Sm). LV diastolic function was assessed by (i) ratio between early rapid filling phage and late rapid filling phage, (ii) deceleration time, and (iii) isovolumetric relaxation time. Statistical Analysis: The statistical calculations were done with the use of the statistical software SPSS 19. We analyzed the association of LV diastolic dysfunction with the variables (age, CXR, Global Initiative for Chronic Obstructive Lung disease [GOLD] staging, ECG, dyspnea, and duration of illness) of COPD patients by Chi-square test and the test of significance was defined by P value <0.05. Results: Most patients were in GOLD stages II and III (44 and 30%, respectively). ECG was abnormal (like p-pulmonale, low-voltage complex, right bundle branch block, etc.) in 92.30% of patients. LV diastolic dysfunction was demonstrated in 84% of patients who were mostly in GOLD stages II and III with duration of illness ≥5 years and had ECG and CXR abnormalities. Isolated systolic dysfunction was not observed. We found a statistically significant association between the prevalence of LV diastolic dysfunction with the patients’ age, duration of illness, GOLD staging, ECG, and CXR findings (P < 0.001). Conclusions: LV dysfunction should be considered as a cause when COPD patients do not respond to the standard treatment protocol.
Treatment Options Used in COVID-19 Disease
Authors: Patil Shital , Narwade Ganesh , Gondhali Gajanan
Published: May 2024

Coronavirus disease 2019 (COVID-19) is the first coronavirus-related global pandemic caused by a novel severe acute respiratory syndrome coronavirus-2, and rapid evolution of the pandemic has resulted in fast-track developments in antivirals, medical management, and vaccination for use to prevent morbidity and mortality. As of today, different institutional treatment protocols and respective national guidelines have been evolved worldwide with team of medical experts and recommended for combinations of antiviral, antibiotics, steroids, and anticoagulants with variable outcomes. Combination therapy has documented better outcome with a significant reduction in mortality and morbidity and considered frontline protocol during this pandemic.
Askin's Tumor – A Dual Case Study of Rare Thoracic Neoplasm
Authors: Vinay V , Dubey Praveen Kumar , Singh Kuljeet , Saini Jitendra Kumar , Iyer Srinath Shankar , Srivastava Alpana
Published: May 2024

Askin's tumor is a primitive neuroectodermal tumor (PNET) that belongs to the class of small round cell malignant tumor. It has a poor survival rate as it is an aggressive tumor with high chances of recurrence. It poses a diagnostic and therapeutic challenge to the clinicians as it mimics conditions such as tuberculosis, lymphoma, and rhabdomyosarcoma. With a special interest to improve the management of this condition, we report a mini-series of two cases of this rare malignancy.
Can Researchers Write their Articles by Artificial Intelligence?
Authors: Mondal Himel , Mondal Shaikat
Published: May 2024

The advent of artificial intelligence (AI) has sparked considerable interest in its potential applications across various domains, including scientific research and academic writing. However, many academicians are apprehensive about it because of ethical issues. This article explores the question of whether researchers can leverage AI to write their articles. By analyzing an existing model of taking assistance from third-party editing services, it is clear that the usage of AI in writing articles may not be considered unethical. However, authors must clearly mention for what purpose the AI was used and must acknowledge the help. Due to ease of accessibility and proven proficiency, researchers who cannot afford third-party writing services can harness the service of large language models like ChatGPT, Google Bard, Microsoft Bing, Perplexity, Claude, etc. and other AI applications for writing their scientific articles.
Pancreatitis Associated Uremic Encephalopathy Presenting with Lentiform Fork Sign
Authors: Nair Rahul , Sharma Chandrabhushan , Sekhar Sulakshana
Published: May 2024

Lentiform fork sign is a rare neuroradiological abnormality with bilateral basal ganglion changes. It is seen in a variety of conditions characterized by metabolic acidosis, mostly seen with uremia of diabetic end-stage renal disease. Metabolic acidosis associated with uremia of acute pancreatitis has never been reported to be associated with this sign. Features of uremic encephalopathy are reversible with hemodialysis. The onset of worsening neurological symptoms along with a lack of improvement in encephalopathy despite hemodialysis must prompt the physician to do Magnetic Resonance Imaging (MRI) Brain in search of this sign. The scope of acute pancreatitis in its causation also needs to be investigated further. We report a case of acute kidney injury in a patient with acute pancreatitis who presented with metabolic acidosis and uremic encephalopathy. After initial improvement with hemodialysis, he gradually and sequentially went on to develop quadriplegia, generalized rigidity and distal upper limb tremor and later on full recovery along with lentiform fork sign on his MRI brain.
Association of Inflammatory Markers, Neutrophil-Lymphocyte Ratio, and D-Dimer with Mortality in COVID-19 Infection
Authors: Rai Deependra Kumar , Ranjan Alok , Pandey Sanjay Kumar , Vardhan Harsh
Published: May 2024

Introduction:

To assess the association of blood biomarkers such as C-reactive protein (CRP), serum ferritin, lactate dehydrogenase (LDH), neutrophil-lymphocyte ratio, and D-dimer at admission with in-hospital mortality in COVID-19 and to determine best predictive cut-offs for them.

Materials and Methods:

This cross-sectional study included 984 confirmed cases of COVID-19 admitted in months of July and August 2020. The optimal biomarker cut-off points for mortality were defined by a receiver operating characteristic curve. Survival probabilities were estimated by the Kaplan–Meier method and compared with the log-rank test.

Results:

The overall mortality rate among the hospitalized cases was 254 (25.81%). All the markers were found to be significantly higher (P < 0.001) in nonsurvivor group as compared to the survivors at the time of admission. Serum CRP, ferritin, D-dimer and LDH were found to be elevated, i.e., higher than the upper limit of normal range in 426 (83%), 469 (68.37%), 449 (67.9%), and 380 (93.1%) respectively overall. However, these markers were significantly more elevated in nonsurvivor compared to survivors. A significant increasing trend of elevated level of all biomarkers was observed with increase of severity level (P < 0.0001). It was found that CRP ≥82 mg/L had sensitivity of 63.58% and specificity of 68.38% for predicting the mortality. Similarly, serum ferritin ≥475.6 mg/ml had sensitivity of 68.09% and specificity of 65.26%, D-dimer ≥0.65 had sensitivity of 90.71% and specificity of 55.45%, and LDH ≥915 U/L had sensitivity of 69.34% and specificity of 73.8% to predict the mortality. Furthermore, neutrophil and lymphocyte count ratio (NLR) ≥8.86 had sensitivity of 65.61% and specificity of 79.7% to predict the mortality.

Conclusion:

Levels of the blood biomarker such as CRP, serum ferritin, LDH, NLR, and D-dimer at admission can predict mortality in COVID-19 infection.
Assessment of Knowledge, Attitude, and Practices of Indian Medical and Engineering Students on COVID-19
Authors: Priyadarshini Bhagyajyoti , Mondal Himel , Swarup Shiba Sai , Behera Joshil Kumar , Panigrahi Akankhya , Basu Ankan
Published: May 2024

Background:

Coronavirus disease (COVID-19) has created fear, misconceptions, and apprehensions among the public including the youth of the society. We evaluated and compared the knowledge, attitudes, and practices toward COVID-19 among undergraduate medical and engineering students of India.

Methods:

An online cross-sectional survey was carried out on Indian undergraduate medical and engineering students in September 2020. A prevalidated and pretested questionnaire was used in this study. The questionnaire had eight items for knowledge, six items for attitudes, and four for practices. A snowball sampling method was used to collect data.

Results:

A total of 1757 (1137 [64.71%] medical, 620 [35.29%] engineering) Indian students participated in the study. The overall scores of knowledge were 5.77 ± 1.2, the attitude was 5.06 ± 0.83, and practices were 2.32 ± 0.93 (analysis of variance P < 0.0001). There was no gender difference in knowledge, attitude, or practice. The medical student scored higher in knowledge (P < 0.0001) and attitude (P < 0.0001) compared to engineering students. Medical students showed a significant positive correlation (r = 0.13, P < 0.001) of attitude with semester of study. Engineering students showed significant positive correlation of knowledge (r = 0.12, P = 0.002) and practice (r = 0.11, P = 0.008) with semester of study.

Conclusion:

Indian medical and engineering students had a good level of knowledge and positive attitudes towards COVID-19. Although medical students scored higher in knowledge and attitude, the practice showed no difference. The practice scores were the lowest among the three parameters. This reaffirms the need for more strategic planning to ensure good practices among students of both the major sectors of science.
Adjunctive Use of Autologous Platelet Concentrates in Surgical Management of Periodontal Osseous Defects
Authors: Sukalkar Shrushti Mahendra , Kini Vineet
Published: May 2024

The autologous platelet concentrates (APC) comprise of platelet rich plasma (PRP) and platelet rich fibrin (PRF). These platelet concentrates provide a rich source of growth factors and have been used alone or in combination with bone grafts (BG) during open flap debridement (OFD) to treat various periodontal osseous defects. This literature review was performed to assess the effect of adjunctive use of autologous platelet concentrates (APC) in the surgical management of periodontal osseous defects. Literature search was performed through the databases of national library of medicine and EBSCO host using PubMed and Google scholar search engines and manual searches in which 36 randomized clinical trials (RCT) meeting inclusion criteria that evaluated the healing outcomes of Probing depth (PD) reduction, gain in clinical attachment level (CAL), radiographic bone fill and defect fill in intervention of OFD+APC / OFD+BG +APC as compared to OFD/ OFD+BG in the treatment of periodontal osseous defects published between 2001 to 2019 were assessed. Upon assessment of literature the adjunctive use of APCs appears to have an additive effect to open flap debridement alone or along with bone grafts in surgical management of periodontal osseous defects.
Single-Step Surgery for Treating Chronic Periodontitis and Increasing the Width of Keratinized Gingiva in Mandibular Anterior Region
Authors: Sawai Madhuri Alankar , Bhardwaj Ashu , Jafri Zeba , Sultan Nishat , Daing Anika
Published: May 2024

Chronic periodontitis is precipitated as periodontal pockets, gingival recession (GR), decreased keratinized gingiva, and vestibular depth (VD). In the mandibular anterior region, it is frequently seen as GR and decreased VD. The development of high frenal attachment due to loss of periodontal support further increases the rate of progression of the disease and compromises the condition of the incisors. As mandibular incisors have short roots, they usually tend to become mobile early during the progression of periodontal disease. In this case report, a single-step surgery was done, which included periodontal flap surgery with bone augmentation in relation to mandibular anterior teeth. Following this, the width of keratinized tissue was increased using Diode laser by deepening the vestibule. This combined procedure can cover the exposed roots and increase the width of keratinized gingiva.
Comparison of Lignocaine Versus Articaine Local Anesthetic Solutions in Periodontal Therapies Administered by Computerized Anesthetic Delivery System
Authors: Vivek Haridas Abhishek , Deepika P. C. , Sharma Medha
Published: May 2024

Objectives:

To compare the depth and duration of anesthesia experienced by the patient between lignocaine and articaine anesthetic solutions and to evaluate pain perception and intraoperative anxiety by computer-controlled injection while administering these anesthetic solutions.

Materials and Methods:

The clinical trial was designed as a randomized, single-center, double-blinded, parallel arm, and comparative study. Examiner and study patients were blinded to treatment assignment during the study. Patients were divided into three groups based on treatment to be performed (Root Planing 30, Curettage 30, and Surgery 20) and were anesthetized with articaine in one quadrant and lignocaine in another quadrant by computer-controlled anesthetic device (WAND®). The duration of anesthesia was self-reported by the patients and was calculated by paired t-test. The pain and anxiety scores were calculated on Wong Baker's Facial Pain/Anxiety Scale' by Chi-square test.

Results:

Articaine had longer duration of anesthesia than lignocaine in all the three groups (P < 0.000). Articaine showed significantly lesser pain scores than lignocaine in Root Planing Group (P < 0.000). There was no significant difference in anxiety scores between different groups.

Conclusion:

Articaine has longer duration of anesthesia. Articaine administration was less painful than lignocaine administration.
Autologous Chin Graft for Implant Site Augmentation Revisited
Authors: Jacob Oliver , Kosala Manab
Published: May 2024

Advanced alveolar bone resorption in the maxillary anterior teeth is a common finding that limits the placement of implants for prosthetic rehabilitation. Autologous bone graft from the mandibular symphysis is one of the oldest techniques in horizontal ridge augmentation techniques for placement of implants in advanced resorption of the alveolar ridge in the maxillary anterior region. This case report revisits the technique carried out using piezoelectric osteotome for harvesting block graft from the mandible to augment the resorbed ridge horizontally to place implant in a young and healthy patient.
The Responses of Different Types of Diabetic Macular Edema after Three Loading Doses of Anti-vascular Growth Factor: Outcomes in Two Medical Centers
Authors: Liang I-Chia , Shen Hsin-Ching , Chang Yun-Hsiang , Pao Shu-I
Published: May 2024

Background:

Diabetic macular edema (DME) is currently treated by anti-vascular endothelial growth factor (anti-VEGF).

Aim:

The aim of this study was to evaluate the effect of intravitreal anti-VEGF in different types of DME classified by optical coherence tomography (OCT).

Methods:

This retrospective study included 161 treatment-naive eyes (116 patients) diagnosed with DME in two tertiary medical centers, which were classified into three groups according to initial OCT finding: diffuse retinal thickening (DRT), cystoid macular edema (CME), and serous retinal detachment (SRD). All eyes received three monthly loading doses of anti-VEGF. Primary and secondary outcomes were the improvement of best-corrected visual acuity (BCVA) and the decrease of central foveal thickness (CFT) on OCT, respectively.

Results:

Among the three groups, there was no significant difference in baseline BCVA (P = 0.137); however, the SRD group had the thickest baseline CFT (P < 0.001). After three loading doses of anti-VEGF, the BCVA of all three groups improved from baseline (DRT vs. CME vs. SRD, P = 0.0002, P < 0.0001, and P < 0.0001, respectively), while the SRD group seemed to have relatively better improvement among three groups although not significant (P = 0.051). The CFTs of all three groups significantly decreased from baseline (P < 0.0001 in all three groups). The CFT decreased the most in the SRD group, followed by the CME group, and the least in the DRT group (P < 0.001).

Conclusion:

Anti-VEGF therapy improved the anatomical structure and function in all types of DME; SRD responded the best.
Autologous Fat Grafting: Whom does it satisfy: Patient or Surgeon?
Authors: Ramesh Patil Bhushan , Manashree Sankhe , Vishwanath Guruswamy
Published: May 2024

Introduction:

Autologous fat grafting (AFG) is a versatile and minimally invasive technique in the hands of the plastic surgeon for the correction of contour and other volume deficits. The objective of this study was to assess the efficacy of correction of these defects using AFG in terms of improvement in appearance, as judged both by patient and clinician evaluation.

Methods:

This prospective study was conducted from 2012 to 2023. Thirty cases of contour and other defects underwent correction by AFG by a single surgeon using a single technique. The patients were evaluated by themselves and by an independent surgeon preoperatively and at 6 months postoperatively using a Likert scale. Data were evaluated using MS Excel, Python 3.9.18, and SPSS Statistics.

Results:

Thirty patients were studied as described. Significant improvement was found across age groups and indications. The improvement in scores was significant, both in the clinician and patients’ self-evaluations and was comparable. No significant complications were encountered.

Conclusion:

AFG appears to be a safe, minimally invasive, consistently reproducible tool for the correction of contour and other volume deficits.
Efficacy of Interlaminar Epidural Steroid Injection for the Treatment of Lumbar Disk Prolapse
Authors: Obiegbu Obinna Henry , Uchechukwu Uchechukwu Chibuzo
Published: May 2024

Background:

Degenerative lumbar spine disease is a common cause of debilitating low back pain often associated with radiculopathy and attendant limb weakness. Several nonoperative treatment modalities have been proposed. Of these, epidural steroid injection has been proffered as a treatment modality to patients not responding to other noninvasive treatment plans.

Subjects and Methods:

This is a retrospective study analyzing the efficacy of patients with lumbar disk prolapse who received interlaminar epidural steroid injection. The injectate was made up of 80 mg of methylprednisolone and 2 mL of plain bupivacaine.

Result:

Out of 42 patients, there were 25 males and 17 females. The mean preinjection Oswestry Disability Index (ODI) score was 60.83 ± 7.48, whereas the mean postinjection ODI score at 1 and 6 weeks, respectively, was 34.76 ± 10.06 and 35.60 ± 14.15, respectively; this was statistically significant (P < 0.05).

Conclusion:

Interlaminar epidural steroid injection is an effective treatment modality in patients with symptomatic lumbar disk prolapse.
Evaluation of Total Antioxidant Status among Pediatric Sickle Cell Anemia Patients and Hemoglobin AA Controls
Authors: Uju Chinenye MaryQueen , Ulasi Thomas Obiajulu , Ezeudu Chijioke Elias , Okpara Henry Chima , Elo-Ilo Jacinta Chinyere , Ezenyeaku Chijioke Amara
Published: May 2024

Background:

Sickle cell anemia (SCA) is a major health problem in many parts of the world particularly in Sub-Saharan African countries. The disorder is characterized by chronic hemolytic events that result in increased generation of free radicals leading to excessive consumption and depletion of body antioxidants.

Aim:

This study evaluated the total antioxidant status (TAS) of children with SCA, aged 1–17 years, comparing findings among steady state, vaso-occlusive crisis and hemoglobin AA (HbAA) matched controls.

Materials and Methods:

Study participants were 50 children with SCA and 50 HbAA matched controls. Sociodemographic characteristics and clinical history were documented using pre-tested interviewer-administered questionnaires. Physical examination was conducted and blood samples collected for serum TAS estimation. Data analysis was carried out using SPSS version 21 and P-value of significance was set at <0.05.

Results:

SCA subjects in vaso-occlusive crisis had lower mean serum TAS level than those in steady state (7.4 ± 3.5 vs 8.4 ± 4.0mmol/L) but this difference was not statistically significant (P = 0.18). The mean TAS level of SCA patients either in steady state (8.4 ± 4.0 mmol/L) or vaso-occlusive crisis (7.5 ± 3.5 mmol/L) was higher than 7.0 ± 4.1 mmol/L for matched (HbAA) controls but the difference was also not statistically significant (F = 1.54, P = 0.09).

Conclusion:

This study shows that the TAS level of SCA children in steady state was higher than that of those in vaso-occlusive crisis, though not statistically significant. This may be an adaptive mechanism to counteract the oxidative stress seen in chronic inflammatory conditions like SCA.
Unmasking Anorexia Nervosa in a Nigerian Female Undergraduate
Authors: Lawal Rafiat O. , Ugalahi Theresa O. , Mosaku S. K. , Oginni Olakunle A.
Published: May 2024

We report a rare case of anorexia nervosa in a 20-year-old woman undergraduate of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. The patient met the ICD-10 diagnostic criteria for anorexia nervosa. The major reason for presentation was amenorrhea. A significant etiological factor in the patient was her belief that gaining weight was linked to the fact that weight while in a romantic relationship was linked to being sexually active. She received psychotherapy, and her diet was modified on an outpatient basis and she made an significant improvement.
The Effects of Flavonoids in Curcumin on Neurobehavioral Deficits in Insulin-resistant Rats
Authors: Mohammed Abdullahi Abiodun , Akinola Oluwole Busayo
Published: May 2024

Background:

Diabetes mellitus is a risk factor for dementia, particularly Alzheimer's disease (AD). In a Wistar rat model, we studied Alzheimer-like symptoms using a high-fat diet (HFD) and streptozotocin (STZ) to replicate insulin resistance and the resulting neurobehavioral abnormalities. Curcumin, a flavonoid in turmeric, was studied for its potential therapeutic effects.

Aim:

This study sought to look at the exploratory, discriminatory, and spatial cognitive indices in rats.

Materials and Methods:

Thirty-six male Wistar rats were randomized into six groups and given the following treatments: olive oil only for control; curcumin only for the curcumin group; HFD and three doses STZ for the diabetic rats; HFD, three doses STZ, and concurrent treatment with curcumin for the protective group; pretreatment with curcumin, then HFD and three doses STZ for a preventive group; and HFD, three doses STZ, and curcumin for a therapeutic group. Subsequently, line and center line crossing frequency assessed rats' exploratory activities; rearing frequency data assessed novel environment behavior. The novel object recognition test and Morris water maze test assessed discrimination and spatial memory. Data were analyzed using one-way analysis of variance and Tukey's post hoc test. P < 0.05 was considered statistically significant.

Results:

Our findings revealed that insulin resistance prolonged escape latency of untreated diabetic rats; contrariwise, curcumin significantly reduced escape latency, increased difference score in novel object recognition paradigm, and increased explorative activities.

Conclusion:

Oral curcumin improves exploratory activity, discriminating memory, and spatial memory in male Wistar rats with AD-like neurobehavioral impairments. Patients with neurobehavioral abnormalities and comorbid insulin resistance may benefit from the flavonoids in curcumin.
Motor Function Test Protocol for Parkinsonian Triad in Rodent Model of Parkinson's Disease
Authors: Sirajo Mujittapha Umar , Murtala Kauthar , Oyem John Chukwuma , Ishola Azeez Olakunle , Owolabi Lukman Femi
Published: May 2024

Over the years, there has been an increase in research on parkinsonism in basic and translational neuroscience. Parkinson's disease (PD) is a progressive neurodegenerative disorder vehemently associated with motor function deficits and other unique features collectively called the Parkinsonian triad, which slightly differs from other movement disorders such as Wilson's disease, tardive dyskinesia, chorea, and athetosis. Parkinsonian triad combines three major motor phenotypes of PD including bradykinesia, rigidity, and resting tremors. Hence, there is a need to review motor deficits protocols to create a set of behavioral protocols that critically address the parkinsonian triad's quantification in PD models. Literature search on Medline and PubMed was conducted to access the articles on the motor function test in a rodent model of Parkinsonism. Search terms include parkinsonism, parkinsonian triad, bradykinesia, rigidity, resting tremors, stepping test, parallel bar test, pole test, and cylinder test. This review shows that bradykinesia characterized by difficulty in movement initiation could be assessed using a stepping test by measuring stepping length and time taken to initiate movement on a wooden ramp. It can also be assessed using a parallel bar test by measuring the time taken to make 90° turn. This turning hesitation is one of the critical features of akinesia. Rigidity is associated with an increase in muscle tone; it is assessed by using a pole test to measure the time taken for the rodent to slide down a smooth pole. Resting tremors is an involuntary, oscillatory movement of the distal part of the upper limb when not performing an action. It could be graded using a cylinder test when the rodent suspends its forelimb on the air in an attempt to climb the wall of the cylinder. In conclusion, the examinations and quantifications of the Parkinsonian triad are required to diagnose parkinsonism in rodent models.
Tuberous Sclerosis Complex in a 20-year-old Female: Delayed Recognition and Life-threatening Outcomes
Authors: Gonzales-Abalos Maria Roma Ignacio , Gonzales May Fernandez
Published: May 2024

Tuberous sclerosis complex (TSC) is a rare, autosomal dominant multisystem disorder affecting the brain, heart, kidneys, lungs, and skin leading to significant morbidity and mortality. We report a case of TSC and highlight the need for prompt diagnosis and proper surveillance to minimize life-threatening complications. A 20-year-old female presented with facial and ungual papulonodular lesions 4 years after being diagnosed with epilepsy at the age of eight. No family history of genetic diseases was reported. Eight years later, the patient developed recurrent cough, shortness of breath, and blurring of vision. Biopsy of facial and digital nodule showed angiofibroma and ungual fibroma (Koenen tumor), respectively. Chest computed tomography scan revealed extensive cystic lesions diffusely scattered throughout the entire lung parenchyma suggestive of lymphangioleiomyomatosis. Cranial MRI revealed cortical and subependymal tubers, compatible with TSC. The patient had multidisciplinary management. However, her symptoms progressed, and she eventually succumbed to death. Cutaneous lesions such as facial angiofibromas and ungual fibromas along with multisystemic manifestations should alarm the clinician to TSC. Given its highly variable expressivity, awareness of different TSC-associated signs and symptoms is essential for prompt diagnosis, proper treatment, disease monitoring, and early recognition of TSC complications.
Syphilitic Unorthodoxy: A Case of Lues Maligna in a Human Immunodeficiency Virus-negative 28-year-old Filipino Male
Authors: Peña Bianca Victoria Castada , Santos Danelle Anne Lazatin , Relova-Haresco Ma. Bianca Therese , Gabriel Ma. Teresita Gonzales
Published: May 2024

Lues maligna, also known as malignant syphilis, is an uncommon variant of syphilis at the secondary stage – more commonly reported in immunocompromised patients or those with concomitant human immunodeficiency virus (HIV) infection. In this report, we present a case of a 28-year-old HIV-negative male with a 9-month history of multiple, well-defined, irregularly-shaped, erythematous papules, and small plaques evolving to ulcerated plaques and nodules with crusts, associated with pain, pruritus, and episodes of fever, arthralgia, and weight loss. Positive treponemal and nontreponemal tests, aided by histopathologic findings consistent with syphilis led to the diagnosis of lues maligna. Significant improvement of lesions was noted with 3 weekly doses of 2.4 million units of benzathine penicillin G. For patients presenting with painful and pruritic erythematous ulcerated plaques with crusts associated with systemic symptoms, and with a significant sexual history despite testing negative for HIV infection, a high index of suspicion for uncommon presentations of other sexually transmitted infections such as syphilis could aid in early diagnosis and subsequent treatment.
Conjunctival attachment of a larvae stage tick
Authors: Fernandes Arthur Gustavo , Carboni Silvia
Published: May 2024

Ocular tick attachment is a rare event; however, it carries a significant risk of tick-borne infections. Hereby, we describe a case of a 29-year-old female in the Amazon region who presented a tick attached to the left nasal bulbar conjunctiva with noticeable dilatation of conjunctival vessels. With no access to a medical center, the patient was guided to mechanically remove the tick by pulling it with sterile forceps. The conjunctiva was freely mobile, and the tick, later identified as Amblyomma spp., was completely removed from the eye. No ocular or systemic tick-transmitted diseases were observed within 6 months of follow-up. The prompt and secure removal of a tick attached to the conjunctiva should be undertaken as soon as possible to prevent the further transmission of pathogens, toxins, and allergens. The removal approach should be based on the tick’s location and the patient’s access to a medical facility.
Choroidal neovascularization in unilateral acute idiopathic maculopathy associated with coxsackievirus B2
Authors: Roizenblatt Arnaldo , Meirelles Rodrigo , Gehlbach Peter Louis , Belfort Rubens , Roizenblatt Marina
Published: May 2024

The purpose of the study was to present a case of choroidal neovascularization (CNV) in unilateral acute idiopathic maculopathy (UAIM) associated with coxsackievirus B2. We present a case of UAIM with coxsackie B2 positive serology, presenting CNV as a complication. Follow-up multimodal retinal imaging was performed to characterize the macular abnormalities further. A 27-year-old woman complained of a sudden central visual field scotoma in her left eye (LE) 2 days before her presentation. The patient reported flu-like symptoms 2 weeks before her initial ophthalmic symptoms. Ophthalmologic examination and multimodal imaging were performed at the initial presentation and 2 months follow-up when CNV was detected. The patient underwent an intravitreous ranibizumab injection in the LE. After the injection, the optical coherence tomography was repeated and there was a partial decrement of the subretinal hyperreflective area, and visual acuity improved to 20/30. To the best of our knowledge, no previous reports were found linking coxsackie B2 infection with UAIM and CNV. The present case report demonstrates the importance of serial multimodal imaging to guarantee accurate diagnosis and effective therapy for patients with UAIM secondary to coxsackievirus infection, regardless of the virus variant involved.
Climate change and eye health
Authors: Waisberg Ethan , Ong Joshua , Masalkhi Mouayad , Lee Andrew G.
Published: May 2024

The negative impact of climate change on human health is well documented but under-recognized (e.g., air pollution, malnutrition, water-source contamination, and altered vector and waterborne transmission of infectious disease). The impact of climate change on eye health remains significantly underappreciated, whereas climate change impacts every country, lower and lesser-income countries will be disproportionately affected further exacerbating global health inequalities. In this manuscript, we examine the potential effects of climate changes on ocular health on our planet.
Psychoactive substance use and associated factors among pregnant women attending antenatal clinic
Authors: Sulyman Dauda , Ayanda Kazeem Ayinde , Aminu Muhammad Bappah , Dattijo Lamaran Makama
Published: May 2024

Background:

There is obvious change in the pattern of psychoactive substance use in this part of the world. The habit which was previously prerogative of adult males has now been extended to women. Women of reproductive age group, including pregnant ones now engage in the use of psychoactive substances, thereby exposing them and their unborn babies to various risks and dangers.

Objectives:

This study was carried out to determine the prevalence rate of use of psychoactive substances among pregnant women attending clinic in a teaching hospital, in a North-eastern State of Nigeria.

Materials and Methods:

It was a cross-sectional questionnaire-based survey. The Alcohol, Smoking and Substance Involvement Screening Test questionnaires were administered to 320 pregnant women that came for antenatal care (ANC) by research assistants.

Results:

The prevalence of substance use among the respondents was 13.3%. Tobacco products in form of snuff and cigarette (34.7%), sedatives and over the counter sleeping pills (32.8%) were commonly abused substances. Opiates in form of tramadol and codeine-containing cough syrups were also common (14.0%). Proportions of respondents that consume alcoholic products were 12.4%, whereas the remaining percentages were for other substances such as cannabis and solvent. Fathers' uses as well as partners' uses of psychoactive substances were variables that were significantly associated with the substance use by pregnant women in this study.

Conclusion:

The proportion of pregnant women that uses psychoactive substances was high in this study, especially when the fathers or partners also abuse substances. Efforts should therefore be made to screen women coming for ANC to diagnose those with substance use habit and manage them appropriately.
Localized tetanus
Authors: Aliyu Mamman Na'uzo , Amagiya Lawson , Abdullahi Zainab
Published: May 2024

Tetanus is a vaccine-preventable disease caused by a potent neurotoxin released following infection with the obligate anaerobic bacterium, Clostridium tetani. Of the four clinical forms of the disease, generalized tetanus accounts for the most common form of the disease. This is a case report of localized tetanus involving the thigh muscles in a 12-year unimmunized girl following a wound sustained around the right groin area initially thought to be an acetabular fracture. The child had antibiotics, antitetanus serum, sedatives, and wound care. She was unable to have full treatment because of parental decision to seek traditional treatment at home. The case is reported because of the rarity of localized tetanus, the diagnostic dilemma presented by the case, and the cultural interplay and understanding of the disease process by the patient/caregivers. It is also reported to highlight the gap in routine immunization and the need for booster doses in this age group.
Neonatal lower limb gangrene
Authors: Salawu Oni Nasiru , Ibraheem G. H. , Mejabi J. O. , Nwosu C. , Ahmed B. A. , Suleiman A. K. , Babalola O. M.
Published: May 2024

Limb gangrene is a common orthopedic emergency in this part of the world, but neonatal limb gangrene is a rare pathology. Sepsis is a common complication of limb gangrene which can lead to mortality if not managed early. Here is a case of left leg gangrene in a 16-day-old female neonate following the application of local cosmetic agent ("lele") by the mother prior to naming ceremony. The patient presented with features of septicemia; she was resuscitated, and left below-knee amputation was done for her. Harmful and unnecessary cosmetics should be avoided in neonates.
A cadaveric study of thoracic paravertebral spaces from the point of view of paravertebral block
Authors: Dayer Moiz Junaid , Bharambe Vaishaly Kishore
Published: May 2024

Background:

Paravertebral block (PVB) is a regional anesthetic technique, in which a local anesthetic is injected into the thoracic PVS, resulting in ipsilateral somatic and sympathetic nerve blockade.

Objectives:

The present study aimed at observing the extent of thoracic paravertebral space (TPVS) at the levels of T1–2, T6–7, and T11–12 by measuring the horizontal and vertical spread of the dye in the Indian population.

Materials and Methods:

Methylene blue dye was injected into the TPVS at the levels of T1–2, T6–7, and T11–12 and its spread observed.

Results:

A total of 25 cadavers were studied. The extent of horizontal the spread was average of 83.0 mm at the level of T1–2, 103.0 mm at the level of T6–7, and 88.2 mm at the T11–12 level. The average vertical spread in the intercostal space at the level of T1–2 was found to 48.1 mm, at the level of T6–7 was found to be 44.6 mm, and at the level of T11–12 was found to be 55.04 mm. The maximum vertical spread of dye was over three intercostal spaces. Sixty-four percent of the cadavers studied showed a spread of dye from TPVS to lumbar paravertebral space. In 20% of the cadavers, a contralateral spread of injected dye was observed. The average depth of the needle to reach the TPVS was observed to be 36.8, 35.7, and 36.1 mm for T1–2, T6–7, and T11–12, respectively.

Conclusions:

A paravertebral block (PVB) has immense potential in regional anesthetic techniques involving thoracic and lumbar dermatomes. The present study will be helpful for surgeons and anesthesiologists to reduce uncertainties of the spread of anesthetic agents in thoracic PVB and its complications.
Correlation of phenotypes of polycystic ovarian syndrome with anti-Müllerian hormone levels
Authors: Santhiya R. , Habeebullah Syed , Ghose Seetesh
Published: May 2024

Background:

Polycystic ovarian syndrome (PCOS) is a frequently encountered endocrine disorders in women of the reproductive age. Various studies conclude there is no uniform correlation between the phenotypes of the PCOS and serum anti-Mullerian Hormone (AMH) levels.

Aim and Objective:

The objective of the study to estimate the association between different phenotypes of PCOS and the serum AMH level.

Materials and Methods:

This was a cross-sectional analytical study which included sixty subjects with PCOS according to Rotterdam's criteria. After procuring the detailed history, clinically examination and ultrasound scan subjects were classified into one of the phenotypes of PCOS. Auto-analyzer was used to measure serum AMH levels and was correlated with the various phenotypes of PCOS.

Results:

The study group categorized 28 patients under phenotype D, which was a predominant form. Serum AMH mean was 6.1 (±3.2) ng/ml. The mean serum AMH levels for phenotype A was 7.5 ± 3.0 ng/ml which was higher than the other phenotypes. Phenotype A had high mean body mass index which was significant (29.1 ±6.6) kg/m2 (P = 0.046). Phenotype B had significantly higher Hirsutism score 19.8 (±1.7). Phenotype A had significantly higher mean follicular count (19.7 ± 5.1). The difference of mean or median among the phenotypes was compared using Kruskal–Wallis test or ANOVA. P < 0.05 was considered as statistically significant.

Conclusion:

A positive correlation was seen between the serum AMH levels and the phenotypes of the PCOS. Thus, AMH levels can be used as an adjunct tool in the diagnosis and monitoring of PCOS.
Have our strictures changed
Authors: Oyelowo Nasir , Ahmed Muhammed , Bello Ahmad , Lawal Ahmad Tijani , Lawal Bola Biliaminu , Olagunju J , Sudi Abdullahi , Awaisu Mudi , Tolani Musliu Adetola , Maitama Hussaini Yusuf
Published: May 2024

Introduction:

Urethral stricture is a common cause of lower urinary tract symptoms in middle-aged and elderly men. Its presentation and management are closely linked with its etiology and this varies across geographical regions of the world as well as overtime. We hereby review the etiology, characteristics, and presentation of men with urethral strictures in a tertiary hospital in northern Nigeria over a year and compare it with previous studies in the region.

Patients and Methods:

The study was a prospective study from January-December 2016, all patients with urethral strictures and who consented to the study were enrolled in the study. Data was collected using a structured study proforma and analyzed using SPSS version 23.

Results:

The mean age was 44.1 years with a range of 13-71 years. The age interval 30 – 39 years accounted for most of the patients 24 (28.6%). 43% of the patients had short segment urethral strictures (<2cm) while 57% had long segment strictures (>2cm). The bulbar urethra was the site of most strictures with a frequency of 65%. Strictures were found in the penile and peno-bulbar urethra in 25% and 21% respectively. Only 10% of patients studied had multiple strictures. The etiology was an infection in the majority of the patients with a frequency of 53.3%. Post-traumatic strictures occurred in 33.3% while iatrogenic and catheter –Induced strictures were seen in 7.1% and 6% respectively. 8.3% had recurrent strictures, 1.2 % had previous dilations and 2.4 % had previous DVIU. 88% had no previous intervention for the stricture before the presentation. The complications from urethral strictures observed in the patients were acute urinary retention in 83.4% urethrocutaneous fistulae in 2.4% and urosepsis in 1.2% of the patients. 11% presented with no complication. 68% of these patients were managed by excision and end to end anastomosis, 15 % had a penile pedicled flap 12%, a buccal mucosa graft urethroplasty and 5% with staged urethroplasty.

Conclusion:

Though there is a gradual rise in post-traumatic and iatrogenic strictures in our environment, Post-inflammatory strictures still predominate. It is however infrequently accompanied by fistulae as seen decades ago. These strictures are mostly long segments single bulbar strictures.
COVID-19 Pandemic as a mass killer and existential public health emergency in Nigeria remains unproven: A viewpoint
Authors: Okoro Emmanuel Obi , Salihu Mumeen Olaitan , Akpila Azibanigha S. , Giwa Ayuba O.
Published: May 2024

Framing COVID-19 pandemic as mass killer and existential public health emergency/threat in Nigeria with 2,120 COVID-19-related deaths in over 14 months of the pandemic in the country is problematic, especially as other public health conditions kill more Nigerians annually. In 2018, for example, malaria and road traffic accident caused 97,200 and 38,902 deaths, respectively, while HIV/AIDS caused 43,000 deaths in 2019. Therefore, rushing into an extensive vaccination campaign projected to cost 540 billion naira when 76.03 billion naira was allocated for primary health services nationwide including other major immunization programs in the 2021 federal health budget could raise question of priority/effective spending. Especially with COVID-19 deaths relative to reported cases (case fatality ratio) declining to 1.30% by June 30, 2021 from 3.45% in April 2020 and daily mass deaths non-evident. Temporizing to understand how the pandemic evolves especially in jurisdictions with higher need could be cost-effective.
Effect of intermittent fasting on cardiovascular parameters of young adult offspring of hypertensive parents
Authors: Adeniyi Olasupo Stephen , Adams Owaita , Ogiator Monday , Musa Danladi Ibrahim
Published: May 2024

Background:

Offspring of hypertensive parents have been reported to have alteration on their sympathovagal balance and have exaggerated response to stressful conditions. Many Christians observe a period of fasting at the beginning of every year, which imposes some stress on their bodies.

Objective:

This study aims to investigate the effect of 21-day intermittent fasting on some cardiovascular parameters in offspring of hypertensive and normotensive parents.

Materials and Methods:

Eighty young adults (20–28 years) were divided into equal number of male and female offspring of hypertensive and normotensive parents based on questionnaire. Their body weight, height, waist circumference (WC), body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded 1 week before the fasting period began and then weekly for 3 weeks, in which they fasted.

Results:

The weight, BMI, and WC reduced during fasting, but the reductions were not significant (P > 0.05). The SBP and DBP were higher in male offspring of hypertensive parents than all other groups. SBP was also significantly (P < 0.05) higher in males than females before fast and during fast. Fasting significantly reduced the SBP in the male offspring of both hypertensive and normotensive parents. The HR reduced in the females during fast but increased from a lower level in males to a value not significantly different from prefasting level.

Conclusion:

Fasting reduces the high SBP and DBP in male offspring of hypertensive parents, which is beneficial to their cardiovascular system.
Evaluation of the Neuroprotective Effect of Lawsonia inermis Flower Extract in Alzheimer’s Disease-induced Zebrafish Model
Authors: Ramasamy Kavitha , Gayathri K. Priya , Cheriyan Binoy Varghese , Josephine I. Glory , Deepti V. D.
Published: May 2024

Objective:

The study aimed to evaluate the effect of Lawsonia inermis flower extract in an Alzheimer’s disease (AD)-induced zebrafish model.

Materials and Methods:

A total of 60 adult fishes were segregated into five groups (n = 12) and treated with various dilutions of L. inermis extract, respectively. The study was conducted in two phases. The effective dilution range was identified in Phase I (7 days), and the respective dilution was used in Phase II (14 days) for sodium valproate-induced AD. The treatment groups were screened for anxiety, motor coordination, and memory using a novel tank diving test, swim velocity, and maze test, respectively. Treated fishes from each group were investigated for histopathology examination. The results were analyzed with a one-way analysis of variance followed by a post hoc Tukey multiple comparison test using GraphPad Prism.

Results:

In Phase I, a dose-dependent reduction of degeneration was observed in the pathology of the brain with no significant changes in cognition. In Phase II, the effective dose (8 μg/day/0.5 mg fish) of L. inermis flower extract has shown a significant reduction in anxiety, degeneration, and motor dysfunction with a significant increase in memory and learning.

Conclusions:

The current investigation has shown that the L. inermis flower extract has a neuroprotective impact on AD zebrafish.