bluuebunny/crossref_metadata_2025 huggingface dataset:
Semen Washing and Intrauterine Insemination for Reducing the Risk of Human Immunodeficiency Virus Transmission in Serodiscordant Couples: A Cross-sectional Study
Authors: Shah Duru , Harjani Raj , Yadav Vishesha
Published: May 2024

ABSTRACT

Background:

Antiretroviral therapy has helped human immunodeficiency virus (HIV)-infected people live an enhanced quality of life and attempt for a pregnancy, without placing their partner at risk. Although periconceptional pre-exposure prophylaxis for the uninfected partner and consistent antiretroviral therapy for the HIV-infected partner are important to prevent HIV transmission, semen washing could be a great option to further reduce the semen viral load.

Aim:

The aim of this study were as follows: to determine if semen washing with intrauterine insemination provides an added safety net to HIV-serodiscordant couples when the male partner is HIV-infected and virally suppressed and to determine if the U = U concept (undetectable = untransmittable) holds true in virally suppressed HIV-infected males.

Settings and Design:

This was an observational study conducted in seropositive HIV men under treatment with highly active antiretroviral therapy (HAART) in collaboration with Metropolis Laboratory, a CAP recognised private Healthcare Laboratory in Mumbai, India.

Materials and Methods:

Blood and semen samples were collected from a total of 110 adult HIV-1-infected males virally suppressed on HAART. These samples were processed to assess the viral load in plasma as well as raw and processed semen fractions.

Statistical Analysis Used:

Descriptive statistics were used to analyse the data.

Results:

Only men with plasma viral loads < 1000 copies were selected in our study. Out of the 110 HIV-infected individuals, 102 (92.73%) patients had undetectable (<20 copies/ml) plasma viral load while 8 (7.27%) patients had a detectable (>20 copies/ml) viral load, who were excluded from the study. In the virally suppressed 102 men, the raw semen samples of 100 men showed an undetectable viral load, while 2 samples showed detectable contamination, even though their plasma samples from the blood showed a viral load of <20 copies/ml. The semen was then separated into the sperm and the seminal plasma samples. The seminal plasma had <20 copies/ml in 95 samples (93.14%) but a detectable viral load in 7 (6.86%) samples. After subjecting all the 102 processed (post-wash) sperm samples to quantitative analysis, an undetectable viral load of <20 copies/ml was found in all the samples. Thus, the raw sample (prewashed),seminal plasma and processed (postwash) samples were evaluated. The post-wash sperm sample showing zero contamination was frozen for intrauterine insemination (IUI) in the uninfected female partner.

Conclusions:

Semen washing with IUI should be advocated as a safe, efficacious way to increase the safety net and to further reduce the minimal risk of HIV transmission in serodiscordant couples in addition to the U = U concept.
Association between Polycystic Ovarian Syndrome, Impaired Kidney Function and Hyperuricaemia: A Systematic Review and Meta-analysis
Authors: Widjanarko Nicolas Daniel , Iskandar Archie Fontana , Suryatenggara Felicia Grizelda , Sylfiasari Rosalia , Leonardo Leonardo
Published: May 2024

ABSTRACT

Background:

Polycystic ovarian syndrome (PCOS) is a gynaecological problem affecting women within reproductive age, accompanied by several metabolic anomalies, thus leading to alteration in kidney function and hyperuricaemia. Due to the high prevalence of cardiometabolic factors in PCOS, there is a need to anticipate an increased number of kidney impairments amongst these women.

Objectives:

This review aims to investigate the potential link between PCOS, impaired kidney function, and elevated uric acid levels. By elucidating this association, we hope to provide clinicians with a tool to stratify the risk of kidney disease in women diagnosed with PCOS, based on readily available kidney function parameters.

Materials and Methods:

The recommendations used for the analysis were outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Subsequently, eligible studies were identified using several databases (MEDLINE, ProQuest and EBSCOhost) between 1996 and 2022, with a total of 13 studies included. Serum uric acid, serum creatinine, as well as estimated glomerular filtration rate (eGFR) were evaluated as the outcome of interest. Quality assessment for cohort, case–control and cross-sectional studies was conducted utilising the Newcastle–Ottawa Scale, while Review Manager 5.4 was utilised for meta-analysis.

Results:

Uric acid was significantly higher in women with PCOS (mean difference [MD] = 0.70, 95% confidence interval [CI] [0.45–0.95], P < 0.00001). Meanwhile, serum creatinine and eGFR were statistically similar in each group (MD = 0.08, 95% CI [−0.05–0.21], P = 0.22 and MD = 3.54, 95% CI [−4.53–11.61], P = 0.39, respectively).

Interpretation:

This review showed that PCOS was significantly associated with elevated uric acid. However, no significant difference was found between eGFR and creatinine levels compared to healthy controls. Routine uric acid assessment in PCOS patients is recommended as a simple tool for risk stratification.

Limitations:

No body mass index (BMI) subgroup analysis was done due to limited BMI reporting in our included studies. Quantitative analysis of all kidney function parameters was also limited by sparse data on urea and albumin.

PROSPERO Registration Number: CRD42023410092 (02 April 2023).
Analysis of current status of and barriers to exercise participation among patients on maintenance hemodialysis
Authors: Tian Xin , Li Xiuli , Deng Jianhua
Published: May 2024

Objective:

The objective of this study was to analyze the current status of barriers to exercise participation (EP) among patients on maintenance hemodialysis (MHD).

Materials and Methods:

A cross-sectional study was conducted on 277 outpatients undergoing MHD in 2 tertiary first-class hospitals in Beijing from February 2023 to June 2023 who were selected using convenience sampling method. The data of patients on MHD were collected using the general information questionnaire, Physical Activity Rating Scale, Exercise Benefits/Barriers Scale (EBBS), and Exercise Self-Efficacy Scale (ESES). The relationship between EP and barriers to EP was analyzed through univariate and multivariate linear regression models.

Results:

Patients on MHD had a low exercise volume score of 13.71 ± 0.68 points and a medium EBBS score of 63.36 ± 0.40 points. Multivariate logistic analysis showed that exercise volume was significantly related to the following four aspects, including low monthly household income per capita (odds ratio [OR] = 86.741, 95% confidence interval [CI] [1.164–6.465], P = 0.042), primary underlying disease of diabetic nephropathy (OR = 45.993, 95% CI [1.353–1.564], P = 0.033), the belief that “fatigue in lower extremities hinders exercise” (OR = 4.697, 95% CI [1.127–19.585], P = 0.034), and the belief that “physical exercise bringing optimistic and positive life attitude” (OR = 0.074, 95% CI [0.007–0.830], P = 0.035).

Conclusions:

Since patients on MHD had low physical exercise volume, the health-care provider should pay more attention on the controllable factors that affect the EP of patients on MHD. Therefore, feasible and effective intervention measures can be formulated based on ESES in clinical nursing.
The burden and psychosocial impact on immediate caregivers of patients with spinal cord injury in a tertiary health facility, Edo State, Nigeria
Authors: Ehwarieme Timothy Aghoghko , Josiah Uzezi , Emina Auwuli
Published: May 2024

Objective:

This study aimed to assess the burden and psychosocial impact of spinal cord injury on the immediate caregivers at a tertiary health facility in Benin City, Edo State.

Materials and Methods:

A descriptive cross-sectional survey design was adopted among 73 family caregivers in the neurological ward of a tertiary health facility using a structured questionnaire as instrument of data collection. Data collected were analyzed using descriptive statistics and multiple logistic regression.

Results:

Findings revealed that an overall mean of 2.73 indicates that the burden on the caregivers was moderate with a moderate psychological impact (m = 2.88) and a high sociological impact (m = 3.12). Factors affecting the caregiving provided by immediate caregivers include social and household responsibilities (94.5%), financial situation (89.0%), family support (83.6%), and health status of the caregiver (80.8%). Age (odds ratio [OR] = 5.67, 95% confidence interval [CI]: 1.23–27.17, P = 0.027), education (OR = 3.75, 95% CI: 1.05–13.39, P = 0.041), and “others” (spouses, siblings, friends, or extended family members) (OR = 3.167, 95% CI: 1.583–6.337, P = 0.001) were predictors for high psychological impact while education (OR = 0.074; 95% CI: 0.015–0.370, P = 0.001) and caregiving role (OR = 3.167; 95% CI: 0. 1.583–6.337, P = 0.001) high sociological impact.

Conclusion:

Majority of the caregivers experience moderate burden, moderate psychological impact, and high sociological impact. Understanding these factors is essential for developing targeted interventions and support services to address the unique needs of caregivers and mitigate the burden of caregiving on their psychosocial health.
Depression and Anxiety in Cancer Patients at a Tertiary Care Center in Central India
Authors: Sharma Ruchi , Sachan Dheerendra , Vyas Devesh , Rajput Manbahadur
Published: May 2024

ABSTRACT

Background and Objectives:

Cancer is a life-threatening disease which can also lead to mental health issues such as depression and anxiety, which add to the burden of illness in cancer patients. This study aimed to describe the prevalence and risk factors of depression and anxiety among cancer patients during treatment.

Materials and Methods:

A total of 128 patients were included in the study. The prevalence of depression and anxiety in patients was assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scale. A cutoff score of ten or more was set to diagnose depression and anxiety, respectively. Various risk factors associated with depression and anxiety were assessed.

Results:

The prevalence of depression and anxiety in cancer patients was 31.25% and 15.62%, respectively. The prevalence of depression was most common in head-and-neck cancer and ovarian cancer, while the prevalence of anxiety was most common in head-and-neck cancer and lung cancer. The prevalence of both depression and anxiety was higher in stage IV versus stage III, in males versus females, and in the age group of 41–50 years. The patients receiving chemotherapy had a higher prevalence compared to those receiving combination treatment.

Conclusion:

Our study demonstrated a high prevalence of depression and anxiety in cancer patients during cancer treatment which is affected by a variety of factors. It highlights the problem of psychiatric burden in cancer patients and the need to address this problem by improving means for the early detection and early administration of treatment.
Efficacy and Safety of Paclitaxel versus Cisplatin with Concurrent Radiotherapy in Central India Patients with Locally Advanced Head-and-neck Cancers: A Randomized, Open-label Study
Authors: Mahobia Vijay , Pawar Amol , Diwan Ashok Kumar , Bandhate Kamal
Published: May 2024

ABSTRACT

Background:

In India, majority of the patients with head-and-neck cancers are diagnosed in the locally advanced stage. The aim of this study was to compare the efficacy and safety of paclitaxel versus cisplatin with concurrent radiotherapy (RT) in patients with locally advanced head-and-neck squamous cell carcinomas (LAHNSCCs).

Materials and Methods:

This was an open-label, randomized study involving 100 patients with LAHNSCC who were randomly divided into two groups: the first group received paclitaxel (Tax, n = 50, 30 mg/m2/week for 7 weeks) and the second group received cisplatin (Cis, n = 50; 40 mg/m2/week for 7 weeks). Both the groups received concurrent RT in a total dose of 66.6 Gy in 37 fractions of 5 days/week over a period of 7.5 weeks.

Results:

The complete (46% vs. 36%) and partial (40% vs. 50%) response rates in the Tax + RT group and Cis + RT group were not significantly different (both P > 0.05). Cis + RT resulted in significantly greater Grade I adverse events (AEs) (P < 0.05). While, Grade II, III, and IV AEs were significantly greater with Tax + RT (all P < 0.05). Overall analysis revealed that the use of Cis + RT was associated with a significantly greater number of patients who were free from AEs (P < 0.05).

Conclusions:

Tax + RT and Cis + RT were equi-efficacious in patients with LAHNSCC. However, Cis + RT had a better safety profile.
Review on Major Bioactive Agents Along with Traditional and Medicinal Uses of Malus domestica
Authors: Awasthi Prakash , Thakuri Rashmita
Published: May 2024

Because they have fewer negative effects than chemical medications, fruit-derived bioactive compounds have gained attention as a regulator against a variety of diseases. Apple is one of the most popular fruits, a rich source of nutritional components, and has high amounts of bioactive substances. Pentacyclic triterpenes, phytosterols, polysaccharides (pectin), and polyphenols are the main structural classes of apple components. The nutritional benefits of apples are completed by vitamins and trace elements. These bioactive compounds found in apples and their peels can promote human health by reducing the risk of cancer, diabetes, inflammation, and cardiovascular disease. This is supported by a growing body of scientific research. The present understanding of apple bioactive compounds and their potential medical benefits for people’s health will be the main emphasis of this review.
Phytochemical Analysis and Antioxidant Activity of Zanthoxylum acanthopodium DC. Essential Oils
Authors: Rahmi Eldiza Puji , Makkiyah Feda Anisah , Septama Abdi Wira , Tasfiyati Aprilia Nur , Dewi Rizna Triana
Published: May 2024

Introduction:

Andaliman (Zanthoxylum acanthopodiumDC), which belongs to theRutaceaefamily, is a plant widely used as a spice in traditional Batak cuisine around the Toba region-Samosir, North Sumatra. The Batak people also useZ. acanthopodiumto treat digestive problems, reduce pain, relieve diarrhea, as an aromatic ingredient, tonic, and increase appetite.

Methods:

This investigation analyzed the phytochemical content and antioxidant activity ofZ. acanthopodiumfruit essential oil. The phytochemical content was studied using total phenol content (TPC), total flavonoid content (TFC), and gas chromatography mass spectrometry, and the essential oil’s antioxidant activities were evaluatedin vitroagainst DPPH, FRAP, and ABTS.

Results:

The results showed that the principal constituents ofZ. acanthopodiumfruit essential oil were D-Limonene, Geranyl acetate,-pinene, and α-Ocimene. In addition, the TPC and TFC of the essential oil were relatively low, at 3.81 mg GAE/g sample and 11.42 mg QE/g sample, respectively. According to the DPPH assay results, the essential oil is effective as an antioxidant with an IC50value of 28.37 ug/mL. However, the FRAP and ABTS assays did not showed antioxidant activity. The different results from antioxidant assays (DPPH, FRAP, and ABTS) may be due to the various time of conducting the assay. The DPPH assay was done immediately after the essential oil extracting process, while the FRAP and ABTS assays were done 3 months later.

Conclusion:

The results indicated that the essential oil has high antioxidant properties and has the potential to be further studied for its pharmacological properties.
Quality Improvement in an Anaesthesiology and Intensive Care Unit Through Pain Assessment and Control
Authors: Yamakova Y , Ivanova M , Popova M , Kurtelova N , Petkov R
Published: May 2024

The aim of the study is to determine whether the assessment of postoperative pain and timely measures to control it improve the quality of medical care in intensive care units (ICUs). To develop an improvement model with a focus on pain assessment and control. 151 patients were included in the study, divided into two groups: a retrospective group (RG)—60 patients and a prospective group (PG)—91 patients. A multimodal approach to pain control was applied to all patients. We administered the Critical Care Pain Observational Tool (CPOT) to PG upon admission to the ICU. Visual analog scale (VAS) for pain assessment was used in all non intubated patients in 6 hours intervals. In the PG, а model for improvement was applied using a PDSA (Plan, Do, Study/ Check, Act) cycle. The following indicators have been used: process, outcome, and balancing indicators. A survey of the PG was also conducted. The developed Model of improvement increased the VAS score reporting success rate from 40 to 95%, which allowed significantly better pain control. In PG the registered CPOT score was 1.71 ± 0.73. 90% of patients in PG have an average VAS score below 5 after the improvement model, while in RG—50% of patients, which is statistically significant (P < 0.001). There was no statistically significant difference in balancing indicators between the two groups. Conclusion: The conducted survey confirmed the positive effect of the model. Quality improvement in the ICU depends on accurate assessment of postoperative pain and timely and adequate treatment.
Tuberculous Paraplegia: Outcome of Operative Intervention
Authors: Obiegbu HO , Ndukwu C
Published: May 2024

Background:

Tuberculosis of the spine, a common manifestation of extra-pulmonary tuberculosis is characterized by vertebral destruction, paradiscal involvement, abscess collection and varying degrees of neurologic affectation. The primary disease caused by mycobacterium tuberculosis complex infects the lungs, lymph nodes of the mediastinum and gastrointestinal tract/ viscera with spinal involvement being secondary and caused by haematogenous spread. Tuberculous paraplegia arises as a complication of spinal involvement.

Aim:

To determine the outcome of operative intervention in tuberculous paraplegia. Methodology: This was a retrospective study involving 10 patients with tuberculous spinal involvement with varying degrees of neurological deficit as defined by both Tuli and ASIA grading. The VAS score, ESR, ASIA grade (both pre-op and post op), Tuli's grade (pre-op and post op) were used to analyze the therapeutic effects of the surgery.

Results:

The mean pre-operative VAS score was 5.9 ±1.8, which significantly decreased to 2.2 ±1.3 six weeks post operatively. The mean pre-operative ESR and CRP was 78.9 ± 11.3mm/hr and 83 ± 13.5 respectively; which both showed a statistically significant decrease post-operatively, p<0.05. All cases achieved an increase of more than one ASIA grade post-operatively.

Conclusion:

Early surgical intervention is beneficial in patients with tuberculous spinal disease with neurologic involvement.
Surgical Outcome of Open Radical Prostatectomy in Nigeria: A Five-Years Single-Surgeon Experience
Authors: Osaghae SO
Published: May 2024

Background:

Organ-confined prostate cancer is curable through surgical treatment by radical prostatectomy.

Aim:

To report initial outcomes of open radical prostatectomy in Nigeria from 2014 to 2019.

Methods:

Open radical prostatectomy in private hospital settings. Thirty-five patients underwent open radical prostatectomy in private hospital settings from 2014 to 2019. A retrospective study of the case notes was undertaken.

Results:

The age range was 56–77 years (mean: 67.7 ± 5.6 years); presenting total PSA 7.3–32.0 ng/ml (mean: 16.2 ± 6.4); Gleason score range 6–10 and clinical stage T2c. Mean operation duration 192.4 ± 52.0 min. All patients received blood transfusion (average blood transfusion 4.58 ± 1.9 pints). The median length of hospital stay was 7 days and the catheterization duration was 16.6 days. The Gleason score ranges from 6 to 10. Biopsy and specimen histology Gleason scores correlated in all cases. Biochemical relapse within 1 year occurred in 12 (34.3%) patients. Adequate PSA control was achieved in 23 (65.7%) patients. Two cancer-related deaths occurred within 2 years of surgery. All patients voided well following removal of the catheter; persisting mild stress urinary incontinence resolved on conservative measures within 3–6 months. Anastomotic stricture occurred in one patient 1 (2.9%) in this present. Information on preoperative potency rate was unavailable; however, postoperation, 11 (31.4%) patients achieved erections sufficient for intercourse with oral therapy. All surviving 33 (94.3%) patients reported satisfactory performance status.

Conclusions:

Open radical prostatectomy was successfully performed in all the patients. Reasonable, comparative functional, and oncological outcomes were achieved during the study period.
Intra-articular Calcaneal Fractures: A Report of Cases and Comments on Preoperative Management
Authors: Acar E , Fitzpatrick K , Flint K , Weber T
Published: May 2024

Objectives:

To present a review of the clinical characteristics, preoperative and surgical management, and outcomes of patients with intra-articular calcaneal fractures who had open reduction and internal fixation (ORIF) and to offer some comments on and research ideas for the preoperative management of patients with these fractures.

Patients and Methods:

We studied consecutive patients who had ORIF performed by a single surgeon for closed, intra-articular calcaneal fractures at our level-1 trauma center between 5/29/2012 and 3/20/2018. All inpatients were treated with a preoperative soft tissue management protocol, whereas outpatients were not. Data were obtained about demographic and clinical characteristics, times from injury to surgery, quality of fracture reductions, and complication rates.

Results:

Mean follow-up for the 72 patients with 77 calcaneal fractures was 8.5 (range: 1–43) months, and 21 (27.3%) fractures received inpatient preoperative care with a soft tissue management protocol, while 56 (72.7%) received outpatient preoperative management. More of the fractures treated preoperatively as inpatients versus outpatients were classified as Sanders type III (66.7% vs. 32.1%) and type IV (8.9% vs. 4.8%) fractures and were associated with polytrauma (38.1% vs. 7.1%) and diabetes mellitus (9.5% vs. 5.4%), respectively. For all patients, the mean time from injury to surgery was 12.2 (range: 2.7–19.4) days, and the time was 6.3 days for inpatients and 14.4 days for outpatients, but the quality of fracture reductions and complication rates did not differ between these two groups.

Conclusions:

Patients with intra-articular calcaneal fractures treated as inpatients and receiving a preoperative soft tissue management protocol had outcomes after ORIF that were not inferior to those experienced by patients treated preoperatively as outpatients, despite a greater proportion of the inpatients having severe fractures, polytrauma, and diabetes mellitus. Dedicated preoperative soft tissue management protocols may be beneficial for patients with calcaneal fractures and warrant further study.
Distal Locking of Proximal Femoral Nails in Intertrochanteric Fractures: A Comparison of Taloned and Static Locking Systems
Authors: Karagoz B , Keceli O , Agir I
Published: May 2024

Background:

The necessity of distal locking in proximal femoral nails (PFNs) used in intertrochanteric fracture surgery is still controversial. However, the newly designed talon distalfix PFN differs from other PFN systems with its taloned distal locking (TDL) mechanism.

Aim:

To compare the radiologic and functional results of this newly designed TDL system and the static distal locking (SDL) system.

Methods:

Between January 2018 and December 2021, 142 patients over the age of 65 who underwent PFN surgery for intertrochanteric fractures in our department and underwent SDL or TDL as the distal locking mechanism were analyzed. The patients were divided into two groups as SDL and TDL according to the type of distal locking applied. Demographic variables and intraoperative data (operative time, intraoperative bleeding amount, and fluoroscopy time) were recorded. Harris hip score and Visual Analog Scale (VAS) score results were recorded to evaluate postoperative functional outcomes. Union time and all postoperative complications were recorded.

Results:

Of a total of 142 patients with a mean age of 77.51 ± 11.67 years, 79 underwent SDL and 63 underwent TDL. Operative time, intraoperative bleeding amount, and fluoroscopy time were significantly reduced in patients who underwent TDL compared to those who underwent SDL. The union times were found to be significantly shorter in TDL patients. There was no significant difference between the groups in terms of postoperative Harris hip score and VAS score results and complications.

Conclusions:

This clinical study confirms that TDL is as effective and safe as SDL. In addition, TDL has been shown to have advantages over SDL with shorter operative time, less bleeding amount, and less fluoroscopy time.
Effect of Age and Parity on Physiological Changes in the Eye During Pregnancy: A Prospective Longitudinal Study
Authors: Nwachukwu NZ , Agu PU , Nnagbo JE , Nwachukwu DC , Ugwu EO
Published: May 2024

Background:

The hormonal and metabolic changes that occur during uncomplicated pregnancy affect the eye. The effects of maternal age and parity on the physiological eye changes in pregnancy have been scarcely documented.

Aim:

To determine these effects on some physiological eye changes that occur in pregnancy.

Methods:

A longitudinal study involving consecutively recruited 140 pregnant women aged 18–48 years attending antenatal clinic at the University of Nigeria Teaching Hospital, Enugu. A structured questionnaire was administered to consenting women, after which the Schirmer test, tear break-up time (tBUT), corneal sensitivity, central corneal thickness (CCT), and intraocular pressure (IOP) was measured in the second and third trimesters, and six weeks after delivery.

Results:

The mean CCT showed a significantly greater increase among the multiparous (≥para 2) women in both the second and third trimesters compared with the primigravida/primiparous women (P = 0.032 and 0.049, respectively). There was no difference in mean CCT between the two parity groups at six weeks postpartum. Women aged 18–35 years showed a significantly greater increase in the mean CCT in the second trimester compared to those aged less than 35 years (P = 0.04). However, there was no difference in the mean CCT between the different age groups in the third trimester and at six weeks postpartum.

Conclusion:

The age and parity of women affect their level of CCT changes in pregnancy. Consideration of this effect may guide clinicians on their approaches to eye care and treatment during pregnancy.
Anatomical and Functional Evaluation of Modified Abbe-McIndoe Vaginoplasty at a Tertiary Care Hospital
Authors: Sinha A , Amrita  , Sinha M , Biswas P
Published: May 2024

Background:

Mayer-Rokitansky-Kuster-Hauser (MRKH) Syndrome, the second important cause of primary amenorrhea, is characterized by complete mullerian agenesis in the presence of normal karyotype and normal functioning ovaries. Incidence is one in 4500 females. Treatment options include surgical and non-surgical methods. Surgical treatment by creating a neovagina between bladder and rectum is preferred as it gives immediate results.

Aim:

To evaluate the anatomical and functional outcomes of modified vaginoplasty procedures conducted in our institution.

Methods:

An ambispective cohort study was conducted in the Department of Obstetrics and Gynaecology, at a tertiary care hospital and included 10 cases of MRKH syndrome, who underwent surgical treatment in our department. Postoperative outcome was noted. Sexual function was evaluated using the Female Sexual Function Index (FSFI) score.

Results:

The mean duration of surgery was 40 minutes. The average blood loss during surgery in patients undergoing vaginoplasty was 60 ml. The mean length of the neovagina as measured 1 month after surgery was 7.9 cms. FSFI score was >30 in eight patients. Two patients were lost to follow-up.

Conclusion:

Modified McIndoe vaginoplasty is a simple, safe, and cost-effective procedure in the hands of experts. Only mature patients willing to follow the instructions and planning to get married soon should undergo this surgery.
Burnout and Job Satisfaction among Lecturers in Public Universities in Enugu State, Nigeria
Authors: Aguwa EN , Shu EN , Conable JE
Published: May 2024

Background:

There is increasing awareness of burnout and job disaffection among many professions like health profession, teachers, armed personnel and lawyers. However not much has been studied about university lecturers.

Aim:

To obtain the prevalence and determine predictors of burnout and job satisfaction among lecturers in public universities in Enugu State, Nigeria.

Methods:

It was a cross sectional analytical study. The participants were academic staff from University of Nigeria Nsukka and Enugu State University of Technology who met inclusion criteria. They were selected using multistage sampling technique. Data were collected using Oldenberg Burnout Inventory for burnout and Job Descriptive Index for job satisfaction.

Results:

A total of 392 lecturers were studied: The males were 221 (56.3%), and the modal age group was 41–50 years: 152 (38.8%). The majority were married 303 (77.3%) and had worked for ≤10 years (65.8%). The prevalence of burnout was 57.7%. In general, 150 (38.3%) had a high level of job satisfaction. However, in most facets, < 50% were satisfied. Most socio-demographic variables were not associated with either burnout or job satisfaction. There is significant association between burnout and job satisfaction. Almost all 205 (90.7%) who had burnout had low job satisfaction and this was statistically significant (p value = 0.011). Present work condition, pay, opportunities, supervision were used as predictors to level of burnout. Present condition of work was a significant contributor (p = < 0.001).

Conclusion:

The prevalence of burnout was high and many had low to moderate job satisfaction. Most socio-demographic variables were not associated with burnout or job satisfaction. There was a negative association between job satisfaction and burnout.
Prevalence of Obesity among Adults Visiting Otorhinolaryngology Clinics for Snoring
Authors: Alhedaithy Alhanouf A , Aldilaijan Khalid , Alnosair Abdulmajeed , Jebakumar Arulanantham Zechariah
Published: May 2024

Introduction:

This study aims to assess the prevalence of obesity and to estimate the risk of obstructive sleep apnea (OSA) among adults visiting otorhinolaryngology (ORL) clinics for snoring.

Methods:

We conducted a retrospective chart review of adult patients who visited ORL clinics at King Fahd Military Medical Complex for snoring in the period between October 2019 and March 2022. We utilized STOP and STOP-BANG screening tools to stratify OSA risk in the included subjects.

Results:

Eighty-five patients were included in this study. Most of the subjects were male (80%). Obesity was detected in 63 (74.1%) of the included subjects. Seventy-seven subjects (90.6%) were independently at risk of OSA based on the STOP-BANG questionnaire and STOP questionnaire.

Conclusion:

Obesity is common in adults visiting ORL clinics for snoring. The rate of OSA risk is high among adult patients visiting ORL clinics for snoring. Therefore, it is important for ORL practitioners to utilize OSA risk assessment tools and to have enough knowledge or access to sleep medicine clinics for diagnostic and therapeutic purposes.
Safety and Efficacy of Adenotonsillectomy in Sickle Cell Disease Patients with Obstructive Sleep Apnea – A Scoping Review
Authors: Almutairi Nasser K. , Almofada Hesham , Almatrafi Sharif
Published: May 2024

This scoping review aimed to determine the safety and efficacy of adenotonsillectomy in patients with sickle cell disease (SCD) and obstructive sleep apnea (OSA). Six databases were searched from inception till December 2022 to identify relevant articles, and five articles were selected. Standardized mean difference and 95% confidence interval were used as the effect sizes of the pooled data. Adenotonsillectomy was associated with a significant decrease in the apnea–hypopnea index and a significant increase in nadir O2 and SpO2. However, no differences were detected in the mean annual rates of acute chest syndrome and pain episodes. Adenotonsillectomy appears to improve the health status of SCD patients with OSA and was associated with a wide safety margin. Nevertheless, we recommend larger sample sizes with extended follow-up periods to confirm our findings.
Does Vocal Fold Pathology Play a Role in Determining the Timeline of Presentation to an Ear, Nose, and Throat Surgeon?
Authors: Nerurkar Nupur Kapoor , Jahnavi
Published: May 2024

Background:

The primary objective is to study the average time duration between the onset of vocal symptoms and presentation to an ear, nose, and throat (ENT) surgeon, in different vocal pathologies. Our second objective is to study gender distribution among various pathologies.

Methods:

Our voice clinic records were retrospectively reviewed for 1 year, from August 2022, for details regarding gender, and the average time taken for presentation (ATTFP) in months, to an ENT surgeon. Disorders were grouped into vocal fold nodules, polyps, cysts, paralysis/paresis, sulcus, spasmodic dysphonia (SD), and premalignant and malignant conditions.

Results:

A total of 17 patients of vocal fold nodules (15 females), 47 vocal fold polyp patients (45 males), 40 vocal fold cyst patients (24 females), 64 paralysis/paresis patients (44 males), 41 sulcus patients (31 males), 35 SD patients (22 females), and 65 premalignant and malignant condition patients (51 males) presented to us. The ATTFP for nodules was 8.1 months, 6.8 months for polyps, 10.2 months for cysts, 22.8 months for idiopathic and 6 months for other causes of paralysis/paresis, 32.4 months for sulcus, 26.1 months for SD, and 10.2 months for premalignant and malignant conditions.

Conclusion:

Sulcus patients took the longest time to present to an ENT surgeon, followed by SD patients, both groups averaging over 2 years. Vocal fold paralysis/paresis patients with a nonidiopathic diagnosis were the earliest to present. A high male preponderance in vocal fold polyps (96%) as opposed to a high female preponderance in vocal fold nodules (88%), both considered phonotraumatic lesions, warrants further research into possible varying etiopathogenesis.
Hearing Rehabilitation in a Pediatric Patient with Osteogenesis Imperfecta
Authors: AlMazroa Leen Mohammad , AlHazmi Rawan M. , AlMuhawas Fida A.
Published: May 2024

Osteogenesis imperfecta (OI) is a cluster of genetically determined disorders of the connective tissue. Among the complications associated with this disease, hearing loss is a common complaint that usually begins in the second or third decade of life and worsens with age. Herein, we present the case of a 16-year-old female diagnosed with OI, who presented with decreased hearing over the past 4 years and had a positive family history of OI. Pure tone audiometry revealed mild-to-moderate bilateral conductive hearing loss. This patient’s age illustrates the importance of identifying the best technique for hearing restoration in younger populations.
The impact of Helicobacter pylori infection on lipid metabolism independent of other risk factors for atherosclerosis
Authors: Mostafa Neveen R , Ali Abeer AM
Published: May 2024

Background

Helicobacter pyloriis a common pathogen that is prevalent worldwide, it is known by its effect on gastrointestinal tract, as it causes gastritis, gastric ulcer, and gastric carcinoma.

H. pyloriinfection contributed to other nongastric systemic diseases including cardiovascular and metabolic diseases.

Some epidemiologic studies, found thatH. pyloriinfection is related to cardiac risks such as dyslipidemia, hypertension, obesity, and diabetes mellitus, but other studies failed to find any correlation. WhetherH. pyloriinfection is contributing to cardiovascular disease by affecting its risk factors or not; need further studies.

Aim

Study the effect ofH. pyloriinfection on lipid metabolism as one of the cardiovascular risk factors, independent of other risks.

Patients and Methods

Thirty patients havingH. pyloriinfection and 30 patients without infection were examined for their lipid profile, provided that there is no other risk factor for cardiovascular disease, and the patients are not on treatment for dyslipidemia.

Results

No correlation betweenH. pyloriinfection and dyslipidemia was found.

Conclusion

Infection withH. pyloriis not related to changes in lipid profile provided that there are no other risk factors for dyslipidemia.
Histological study of the effect of curcumin on indomethacin-induced ileitis in adult male albino rats
Authors: Abd-Elbaky Rana Fayez , Badr Shimaa M , Kandeel Samah , Zamzam Abd-El Moniem F
Published: May 2024

Background

Ileitis induced by indomethacin represents a well-standardized model in the study of acute and chronic inflammation of the intestine. Curcumin is an orange-yellow component of the herb turmeric. It has potent anti-inflammatory, antioxidant, antimicrobial, and anticancer effects.

Aim

This work was performed to show the effect of curcumin on indomethacin-induced ileitis in rats using H&E stain.

Materials and methods

Thirty-six mature male albino rats (160–200 g) were used in this study. They were separated into four formain groups; control group: 8 rats, group I: 8 rats that received oral aqueous suspension of curcumin 100 mg/kg daily; group II: 10 rats included subgroups (IIA & IIB): ileitis was induced by subcutaneous injection of two doses of indomethacin; each dose was 7.5 mg/kg separated by 24 hours, the rats were then killed on the 3rd and the 18th day, respectively, and group III: 10 rats included subgroups (IIIA& IIIB): the ileitis group was treated with an oral aqueous suspension of curcumin 100 mg/kg daily and then the rats were killed on the 3rd and 18th day respectively.

Results

Subgroups IIA and IIB revealed sloughing of surface epithelium in the lumen of the intestine, ulceration, a significant decrease of villus height at H&E sections, and inflammatory cellular infiltration. Subgroups IIIA and IIIB showed marked improvement in the pathological changes of induced ileitis.

Conclusion

Curcumin could decrease ileitis induced by indomethacin in rats. So, it could be useful for the treatment of intestinal injury.
Value of biochemical markers in the diagnosis and prediction of severity of acute appendicitis in children: a prospective randomized study
Authors: El-Shennawy Salama , Elkelany Khaled , Abosayed Yehia , Gouda Faisal , Elshami Naser , Seif Ahmed Salah , Allam Heba Khodary , El-shorbagy Safinaz H
Published: May 2024

Background

Appendectomy is one of the most commonly performed operations. Clinical evaluation of patients with acute appendicitis was the cardinal key point of diagnosis.

Aim

To evaluate the value of serum inflammatory markers in the diagnosis of acute appendicitis and suspicion of complication.

Patients and methods

This study was applied on children from 1 to 16 years old, who were diagnosed clinically as having acute appendicitis. Blood samples were collected from all patients for interleukin 6 (IL-6), C-reactive protein (CRP), white blood cells (WBC), and procalcitonin levels. Appendectomy was done for all patients, followed by histopathological examination for all specimens. The patients operated were classified according to the histopathological results.

Results

Over a span of the 12 months, 64 patients between 1 and 16 years old were operated for appendectomy and the positivity was confirmed by histopathology results. The positive group included 57 (89.1%) patients, while seven (10.9%) patients were included in the negative group. The 57 positive cases were subdivided into two groups: 33 (57.9%) cases had complicated appendicitis, while the other 24 (42.1%) cases had simple appendicitis. The values of biochemical markers: CRP, IL-6, procalcitonin, and WBCs, for all patients were assessed comparing the groups together. It was found that these markers were very significant in the differentiation of different groups.

Conclusion

Routine use of biochemical markers WBC, CRP, IL-6, and procalcitonin in children with suspected appendicitis is very helpful to increase the accuracy of diagnosis and to predict complication.
Assessment of thyroid and parathyroid function in patients treated for laryngeal carcinoma
Authors: Abouammo Moataz D , Shehata Emad M , Elsorogy Hesham A , Abdel-Aziz Mahmoud F
Published: May 2024

Background

The close proximity of both thyroid and parathyroid glands to the larynx puts them at high risk to develop hypofunction from the treatment of cancer larynx.

Aim

Thyroid and parathyroid function evaluation after treatment modalities of cancer larynx.

Patients and methods

Thyroid and parathyroid function was evaluated in 60 patients treated from laryngeal carcinoma. Patients were classified into three groups based on treatment type. Group 1 included patients with primary radiotherapy while group 2 included patients with total laryngectomy and group 3 involved patients with combined total laryngectomy and postoperative radiotherapy. Laboratory assessment of thyroid function included thyroid-stimulating hormone (TSH), free T4, while parathyroid function included corrected serum calcium and parathormone levels. The association of gland hypofunction was studied against tumor and treatment characteristics.

Results

Among the 60 patients; group 1 included 27 patients, group 2 included 21 patients, and group 3 included 12 patients. Twenty-five (41.7%) patients showed high TSH level and low FT4 level indicating clinical hypothyroidism while 12 (20%) patients showed high TSH level with normal FT4 level indicating subclinical hypothyroidism. Twenty-three (38.3%) patients showed normal levels of both TSH and FT4 being euthyroid. Concerning parathyroid function; 19 (31.7%) showed hypoparathyroidism diagnosed by low corrected serum calcium level and confirmed by low parathyroid hormone level.

Conclusion

The study detects the occurrence of hypothyroidism with or without hypoparathyroidism after treatment modalities of cancer larynx emphasizing the need of high clinical suspicion and routine evaluation for early detection of any post treatment thyroid or parathyroid gland hypofunction.
A Review on Foodborne Disease Outbreaks in Bhutan
Authors: Chhetri Vishal , Pokhrel Hari Prasad , Dorji Tshering
Published: May 2024

Foodborne diseases (FBDs) are a public health threat that can result in loss of lives and are a hurdle to socioeconomic development. The Foodborne Disease Burden Epidemiology Reference Group estimated that the annual burden of FBDs in the South-East Asia Region was more than 150 million illnesses, causing about 175,000 deaths. This review paper aims to compile evidence from the published articles and gray literatures on food-related disease outbreaks in Bhutan. Information was generated from the annual health bulletin published by the Ministry of Health and data from the National Early Warning Alert Response Surveillance and Information System hosted by Royal Centre for Disease Control. The laboratory confirmation rate of FBD investigation outbreaks increased from 25.5% (2012–2018) to 91.7% in 2020, as per the National Food Safety Indicator (FSI). At least 0.15% of the total population had suffered FBD from 2015 to 2020, and the baseline report shows that most of the FBD events occurred during hot and wet seasons (June and August). The common pathogen causing FBD was Salmonella species accounting for 42.9% of cases, followed by Shigella species (21.4%). Most of the FBD events were reported in schools (46.5%). The frequency of the reported FBD outbreaks had increased from 8 events in 2015 to 15 events in 2017 and 10 events in 2018. The study confirms the improved surveillance for FBDs in Bhutan and highlights the need to raise public awareness on food safety.
Epidemiology of Geriatric Syndromes among Older People Residing in Six Old-Age Homes of Delhi-NCR
Authors: Kumar Vijay , Chatterjee Prasun , Kumar Deepa Anil , Khan Maroof Ahmad , Bandhu Kr Kalanidhi Kamal , Pushpamma K. K.
Published: May 2024

Introduction:

The frequency of geriatric syndromes (GSs) such as cognitive impairment (CI), depression, and malnutrition among older people residing in old-age homes (OAHs) of Delhi-National Capital Territory Region (NCR) has not been reported. The availability of such data determines the quality of health care. The present study aims to assess the frequency of GS among residents of six OAHs in Delhi-NCR.

Materials and Methods:

The study was carried out after obtaining informed written consent from all participants. The team comprising doctors, physiotherapists, and nurses visited the OAHs and assessed GSs using a psychometrically validated screening tool ICT-BRIEF 30. Other standard tools such as Snellen's chart, whisper voice test, mini nutritional assessment, time up and go test score, Mini-Cog, and geriatric depression scale 5 were used to assess vision, hearing, nutrition, mobility, cognition, and mood, respectively.

Results:

Out of 131 participants, low vision was observed in 69.47%, hearing impairment in 20.61%, malnutrition in 12.9%, risk of fall in 18.32%, CI in 46.56%, and depression in 62.59% of the participants. Hearing impairment was found to be significantly associated with quality of life and cognition.

Conclusion:

The present study from Delhi showed high frequency of vision impairment, CI, frailty, depression, and malnutrition in older people residing in OAHs. 20% of the participants had functional loss due to various reasons. Hence, the owner/caretaker of OAHs of Delhi/NCR needs to be proactive in screening the residents for various GSs to provide quality care to the residents.
Prevalence, Serotype Distribution, and Antimicrobial Susceptibility Profile of Streptococcus Pneumoniae among Patients with Acute Respiratory Tract Infection
Authors: Safari Dodi , Widhidewi Ni Waya , Paramaiswari Wisiva Tofriska , Lila Paramasatiari Anak Agung , Maharani Putri Hanifah Fajri , Asih Ratnadi I. G. A. , Sastrawan I. Gede Agus
Published: May 2024

We investigated the nasopharyngeal (NP) carriage and antimicrobial susceptibility profile of Streptococcus pneumoniae among adults and children with acute respiratory tract infection (ARTI). NP swabs were collected from ARTI patients in Tabanan, Bali, Indonesia, in 2017. Serotyping of S. pneumoniae and antibiotic susceptibility profile were performed by multiplex sequential PCR and the disk diffusion method, respectively. Out of 200 ARTI patients, S. pneumoniae strains were carried by 22.6% and 2.4% of children (36/159) and adults (1/41), respectively. Serotype 6A/6B was the most common serotype among cultured strains (21%) followed by 19F (18%) and 14 (8%). Most isolates were susceptible to chloramphenicol (87%), followed by clindamycin (74%), erythromycin (72%), sulfamethoxazole-trimethoprim (59%), and tetracycline (44%). This finding provides baseline information on the serotype distribution of S. pneumoniae carriage among ARTI patients in Indonesia.