bluuebunny/crossref_metadata_2025 huggingface dataset:
Ritualism and Music as Elements in the use of a Minority Language
Authors: Šivic Urša
Published: January 2023

The article is based on field research in various Slovenian minority communities in Austrian Carinthia during the last decade. Caroling, the celebration of a village’s patron’s feast, church services, and funerals are all events associated with ritualism. The role that Slovenian, as the language of the minority, plays in these events is the focus of this study. While the ritual framework is only one of the circumstances in the few spaces where Slovenian is the majority language, the situation in a mostly Germanized environment is quite different. This research shows that ritual events are rare occasions when Slovenian is spoken as a minority language in public places.
Protective effects of protocatechuic acid against doxorubicin- and arsenic trioxide-induced toxicity in cardiomyocytes
Authors: Fatemeh Shafiee , Safaeian Leila , Gorbani Fatemeh
Published: January 2023

Background and purpose:

Some chemotherapeutic drugs are associated with an increased risk of cardiotoxicity in patients. Protocatechuic acid (PCA) is a phenolic acid with valuable cardiovascular, chemo-preventive, and anticancer activities. Recent studies have shown the cardioprotective effects of PCA in several pathological conditions. This investigation aimed to assess the possible protective effects of PCA on cardiomyocytes against toxicities caused by anti-neoplastic agents, doxorubicin (DOX), and arsenic trioxide (ATO).

Experimental approach:

H9C2 cells were exposed to DOX (1 μM) or ATO (35 μM) after 24 h pretreatment with PCA (1-100 μM). MTT and lactate dehydrogenase (LDH) tests were used to define cell viability or cytotoxicity. Total oxidant and antioxidant capacities were evaluated by measuring hydroperoxides and ferric-reducing antioxidant power (FRAP) levels. Expression of the TLR4 gene was also quantitatively estimated by real-time polymerase chain reaction.

Findings/Results:

PCA showed a proliferative effect on cardiomyocytes and significantly enhanced cell viability and reduced cytotoxicity of DOX and ATO during MTT and LDH assays. Pretreatment of cardiomyocytes with PCA significantly decreased hydroperoxide levels and elevated FRAP value. Moreover, PCA meaningfully decreased TLR4 expression in DOX-and ATO-treated cardiomyocytes.

Conclusions and implications:

In conclusion, antioxidant and cytoprotective activities were found for PCA versus toxicities caused by DOX and ATO in cardiomyocytes. However, further in vivo investigations are recommended to assess its clinical value for the prevention and treatment of cardiotoxicity induced by chemotherapeutic agents.
Recent advances in anaesthesia for abdominal solid organ transplantation
Authors: Kumar Lakshmi , Sahu Sandeep , Deo Alka S. , Selvakumar R , Panchwag Ameya A. , Pavithran Priyanka
Published: January 2023

Organ transplantation has undergone remarkable revolution in the last two decades and offers a scope for survival amongst patients with end-stage organ failure. Along with availability of advanced surgical equipment and haemodynamic monitors, minimally invasive surgical techniques have emerged as options for surgery both amongst the donors and recipients. Newer trends in haemodynamic monitoring and expertise in ultrasound guided fascial plane blocks have changed the management in both donors and recipients. The availability of factor concentrates and point-of-care tests for coagulation have allowed optimal and restrictive fluid management of patients. Newer immunosuppressive agents are useful in minimising rejection following transplantation. Concepts on enhanced recovery after surgery have allowed early extubation, feeding and shorter hospital stay. This review gives an overview of the recent progress in anaesthesia for organ transplantation.
A novel approach in understanding the basic modes of ventilation in a recent generation mechanical ventilator– A review of the underlying principles
Authors: Dhulkhed Vithal Krishna , Dhulkhed Pavan Vithal , Katti Anusha Ramachandra , Kurdi Madhuri , Bajwa Sukhminder Jit Singh
Published: January 2023

Understanding the basic concepts and the dynamics of the equation of motion will help the anaesthesiologist and the intensive care physician in gaining an insight into the basics of modern mechanical ventilation. An equation of the type Vt = V0 × (1-e-kt) is often encountered while studying the concepts of mechanical ventilation. This leaves one wondering about the meaning of ‘e’. It is explained as the base of a natural logarithm, and the base e as an irrational constant approximately equal to 2. 7182. In medical literature, various physiological mechanisms are explained by using the exponential function e. However, the explanations do not sufficiently help the learner to demystify the enigmatic term e. In this article, an effort is made to explain this function with the help of simple analogies and relevant mathematical concepts. The process of volume build-up in the lungs during mechanical ventilation is used as a model for the explanations.
Recent advances in cardiac anaesthesia
Authors: Ramachandran Gopinath , Sundar Ayya Syama , Venugopal Vijish , Shah Hetalkumar D , Dogra Neeti
Published: January 2023

The speciality of cardiac anaesthesia has rapidly evolved over the past few decades with advances in technology, including artificial intelligence (AI), newer devices, techniques, imaging, pain relief and a better understanding of the pathophysiology of disease states. Incorporation of the same has led to improved patient outcomes in terms of morbidity and mortality benefits. With the advent of minimally invasive surgical methods, minimising the dose of opioids and ultrasound-guided regional anaesthesia for pain relief, enhanced recovery after cardiac surgery has been made possible. Perioperative imaging including 3D transoesophageal echocardiography, newer devices and drugs and AI algorithms will play a significant role in cardiac anaesthesia. This review briefly addresses some of the recent advances that the authors believe can impact the practice of cardiac anaesthesia.
Correlation of Depression and Anxiety in Type 2 Diabetes Mellitus Patients in a Tertiary Care Hospital
Authors: Kamat Ashok , Kamat Laxmi
Published: January 2023

Context:

People with type 2 diabetes are more likely than the general population to have depressive And anxiety symptoms. Type 2 diabetics are being studied for depression and anxiety.

Aim:

To investigate the Prevalence and correlates of Depression and Anxiety in Type 2 Diabetes Mellitus Patients.

Settings and Design:

The Department of Endocrine and Medicine at Vijaya Hospital in Belagavi, South India, did a descriptive research.

Methods and Materials:

In a study on depression and anxiety, 384 people with type 2 diabetes were administered the Hospital Anxiety and Depression Scale (HADS).

Statistical analysis used:

Descriptive and inferential statistical analysis were done using SPSS software.

Results:

Depression and anxiety were found in 32.56% and 37.76% of the 384 patients assessed, respectively. P = 0.0001 showed a strong connection between anxiety and depressive symptoms (r = 0.7046) in this study. Type 2 diabetes duration, type of therapy and HADS-Anxiety were known to have a significant association. HADS-Depression revealed a significant association with age, qualification, type 2 diabetes duration, and treatment type (P < 0.05) in the same way as HADS-Depression does.

Conclusion:

According to the findings of this study, anxiety and sadness are widespread among people with type 2 diabetes. Furthermore, a strong link between depression and anxiety was observed across a wide range of variables. Depression and anxiety symptoms in people with type 2 diabetes should be assessed and treated on a frequent basis.
Acute Kinematic Changes as a Response to Barefoot Habituation Training Program
Authors: Azeem Zafar , Rathod Priyanshu V , Palekar Tushar J.
Published: January 2023

Context:

Barefoot running has seen a lot of scientific interest in the running community over the last decade. However, there are conflicting claims to its efficacy in improving acute adaptations in the form of joint kinematics. Interventions to transition from shod running to barefoot running are limited in scope and implementation.

Aim:

The study investigated the kinematic differences between barefoot and habitually shod runners following 8 weeks of habituation training. It was hypothesized that the habituation phase with gradual increments in time spent barefoot would result in better kinematic changes in barefoot runners compared to habitual shod (in-shoe).

Setting and Design: Randomized parallel arm trial conducted on professional runners.

Methods and Materials:

Thirty-two (n = 32) professional runners with a mean age of 21.5 ± 2.04 years with standing height measuring 1.69 ± 0.04 m and weighing 69 ± 3.55 kg were selected for the study. Participants were randomly allocated to experimental barefoot and control shod groups using computer-generated sequencing. The barefoot group received an transition plan in which the participants progressed from average time spent in walking and running barefoot. The control shod group was not required to do any changes to their traditional in-shoe training.

Statistical analysis used: The primary outcome measures were joint kinematics at trunk, hip, knee and foot during the treadmill walk analyzed thorough independent T test and paired t test. The level of significance was set at P < 0.05.

Results:

The results indicated that the experimental barefoot group showed statistically significant (P < 0.01) changes to trunk flexion-extension during the preswing phase of running. Similarly, hip flexion-extension ranges were statistically significant (P < 0.01) in the habitual shod (in-shoe) group during the preswing to the terminal swing of running. Hip and knee flexion-extension ranges improved in the barefoot group with a statistical difference of P = 0.00 following 8 weeks of barefoot training. The mean difference for the change in hip and knee flexion ranges was of a higher magnitude for the barefoot group (26.88°) than the shod group (13.23°). Similarly, foot pronation-supination ranges improved for the barefoot group with P = 0.00.

Conclusion:

In conclusion, running barefoot was no different from shod running, although habitually in-shoe athletes, when transitioning to barefoot condition, were essentially better at adopting the natural running style for certain variables.
Case Study
Authors: Raj V. Vijay Samuel , Ukil Kundan Das , Shetty Aparna
Published: January 2023

The deltoid muscle is often forgotten when it comes to the evaluation and planning of treatment in shoulder conditions. Shoulder dysfunction, rotator cuff tendinopathy, and frozen shoulder are the conditions that affect functioning in major cases. The study involved an exploration of possible causes of dysfunction, especially pain and overhead activities. The patient presented with chronic pain and decreased shoulder function. A suitable shoulder rehabilitation program was designed keeping the deltoid muscle denervation into consideration. The shoulder pain, range of motion, strength, and function were evaluated at the baseline and the end of 6 weeks. The results were correlated and explored to identify the involvement of the deltoid muscle. The study showed a positive test of deltoid muscle involvement, which was identified through the strength-duration curve. There was a clinically significant improvement observed in the patients' function. Hence, the study hypothesized that along with scapular stabilization, it is important to consider deltoid equally during the assessment and treatment plan in shoulder rehabilitation program.
Effect of Somatosensory Intervention on Joint Hypermobility and Proprioception in Young Dancers and Nondancers
Authors: Patel Priya , Chivate Shukra
Published: January 2023

Context:

Generalized joint hypermobility is frequent in youngsters, particularly among young dancers. It can cause proprioception problems, discomfort, muscular weakness, musculoskeletal injuries, and joint dislocations. It can be a major source of lower limb injuries in dancers with hypermobility. As a result, it is critical to keep hypermobility under control to avoid damage.

Aim:

The objective of this study was to determine the effect of somatosensory training on joint hypermobility and proprioception in young dancers and nondancers using the Beighton scale and comprehensive scale of proprioception.

Settings and Design: Comparative study in dancers and non dances from dancing academy.

Methods and Materials:

A study was conducted on children with joint hypermobility, in which a total of 18 young dancers and 18 nondancers between the ages of 8 and 15 were selected from Belgaum's dance academy and other coaching classes. On the basis of inclusion and exclusion criteria, the youngsters were screened. Both groups received 15-min somatosensory training 4 times a week for 6 weeks. Beighton score and comprehensive observation of proprioception were used to assess hypermobility and proprioception. The assessment was done at the start of the intervention and again after 6 weeks.

Statistical analysis used: The paired t-test and independent sample t-test were used to compare outcome measures.

Results:

Both groups showed considerable improvements in proprioception and hypermobility with P < 0.001 showing statistical significance. However, when a between-group analysis was performed, the postmean score for hypermobility in Group B was not significant with P = 0.32.

Conclusion:

According to the findings, a 6-week somatosensory intervention improves hypermobility and proprioception in young children.
Effect of Pilates Ring Exercises on Pelvic Floor Muscles in Female with Stress Urinary Incontinence – Randomized Control Trial
Authors: Joshi Reema , Rathi Manisha , Parmar Nidhi
Published: January 2023

Context:

Urinary incontinence (UI) is defined by the International Continence Society as “Involuntary loss of urine which is unhygienic and social embarrassment causes negative self-perception.” UI is a problem which grows silently and causes physical as well as social limitations and deteriorates the quality of life (QOL) of women.

Aims:

The aim of this study is to find out the effect of Pilates exercises using the ring on the pelvic floor muscle (PFM) on PFM strength, severity of stress UI (SUI), and QOL in females with UI.

Settings and Design:

This study was conducted in the Outpatient Department, Dr. D. Y. Patil College of Physiotherapy, Pune, randomized control trial.

Methods and Materials:

Fifty-two females with SUI participated in the study. They were further divided into two groups Group A (experimental group [EG]) and Group B (control group [CG]). For the prepost assessment, vaginal pressure was measured by pressure manometer, core strength, severity of incontinence was assessed by using pad test (1 h) and frequency chart (7 days), QOL was measured using the International Consultation on Incontinence Questionnaire (ICIQ).

Statistical Analysis Used:

Between the groups, analyses were performed using independent t-tests and the Mann–Whitney test. The core strength and the PFM strength show highly significant change with P < 0.05 in Group A compared to B, whereas the severity of incontinence on the frequency chart and QOL with ICIQ were not statically significant.

Results:

EG showed a highly significant difference in PFM and core P < 0.05 in comparison to the control group. While moderate significance was seen in PFM strength and severity of the stress UI.

Conclusions:

The study concludes that Pilates with a ring along with the PFM exercises is a better alternative to only PFM exercise.
Minimal access surgery of corrosive and thermal strictures of the foregut
Authors: Baskaran Vasudevan , Banerjee Jayant Kumar , Ghosh Sita Ram , Kumar Sukumar Santosh , Dey Santosh Kumar , Kulkarni Shrirang Vasant , Bharathi Ramanathan Saranga
Published: January 2023

Background and Aim:

Conventional surgery for caustic/thermal strictures (CS/TS) entails considerable trauma, which may be mitigated by minimal access surgery (MAS). Experience with its use in CS/TS is both heterogeneous and limited, hence, warrants a comprehensive review.

Methods:

Medical literature/indexing databases were systematically searched for pertinent articles published in English, from 1990 to 2021, and analysed.

Results:

Fifty relevant articles, pertaining to over 200 patients, were found. They showed that MAS is feasible in CS/TS management. It reduces the access damage in chest and abdomen whilst facilitating resection or bypass of the affected gut segment through different combination of operations, sequence of steps, conduits and routes. The procedures range from completely minimal access to hybrid ones, with reduced complications and faster recovery. Hybrid procedures prove as expeditious as open ones.

Conclusions:

MAS proves efficacious in restoring alimentary continuity in corrosive/thermal strictures of the foregut.
Clinical experience in laparoscopic treatment of gallbladder perforation
Authors: Zhang Xing-Diao , Wang Xiang-Xiang , Xiong Jie , Liu Ming-Zhong
Published: January 2023

Aim:

We herein present our clinical experience in laparoscopic surgery for gallbladder perforation (GBP).

Materials and Methods:

Retrospective analysis was performed on the clinical data of 44 patients who diagnosed with GBP from January 2015 to November 2020.

Results:

The mean age of the 44 patients was 64.0 years and the female-to-male ratio was 20:24. The most common type of GBP was Type II, followed by Type I and Type III (31:9:4). 72.7% of the patients were diagnosed with GBP at the time of surgery. Laparoscopic surgery was performed for 38 (86.4%) patients, with a conversion rate of 13.2%. The mean length of hospital stays was 7.8 days. The mortality and morbidity rates were 2.3% and 11.4%, respectively.

Conclusions:

Pre-operative diagnosis of GBP is difficult. Laparoscopic surgery is safe, feasible and effective for patients with GBP.
Utility of lactate, central venous oxygen saturation, and the difference in venous and arterial CO2partial pressures (delta pCO2) levels in quantifying microcirculatory failure
Authors: Ayguler Emrullah , Gençay Genco Ali , Demirkol Demet
Published: January 2023

Background:

The aim of the study was to evaluate the utility of lactate, central venous oxygen saturation (ScvO2), and the difference in venous and arterial CO2 partial pressures (delta pCO2) levels and their relationship with the prognosis of critically ill children with circulatory failure in the pediatric intensive care unit (PICU).

Subjects and Methods:

Thirty children with circulatory failure who were admitted to the PICU of a tertiary university hospital between January 15 and November 1, 2020, were evaluated in this prospective observational study. Lactate levels, ScVO2, and delta pCO2 levels were evaluated on admission and at hours 4, 12, and 24 (T0, T4, T12, T24) in the PICU.

Results:

The mortality of the children with circulatory failure was 30% (n = 9). Arterial and venous lactate levels were highly correlated at T0, T4, T12, T24 (P < 0.001; P < 0.001; P < 0.001; P < 0.001, respectively). Nonsurvivors had always higher arterial lactate levels (T0, T4, T12, T24) (P = 0.019, P = 0.007, P = 0.002, P = 0.0003, respectively) and higher delta pCO2 at T0 (P = 0.039) when compared with survivors. Receiver operating characteristic analysis showed that T0 arterial lactate levels (area under the curve [AUC] 0.788, P = 0.019), T24 arterial lactate (AUC 0.918, P < 0,001), and T0 delta pCO2 levels (AUC 0,741, P = 0.039) and were predictive of mortality.

Conclusions:

Lactate remains the most important marker of microcirculatory dysfunction in critically ill children with circulatory failure. Delta pCO2 may be an additional marker of microcirculatory dysfunction in critically ill children.
Acute pancreatitis due to massive hemolysis in a child with glucose-6-phosphate dehydrogenase deficiency
Authors: Kayarat Bhavana , Gutte Shreyas , Pal Sourav , Poddar Banani , Azim Afzal , Gurjar Mohan
Published: January 2023

The incidence of massive intravascular hemolysis causing pancreatitis is 25%; however, it is an often missed entity. Proinflammatory and immunoregulatory cytokines during hemolysis along with heme-induced neutrophil activation, chemoattraction, and disturbance in microcirculation are suggested as causative factors. We describe a case of glucose-6-phosphate dehydrogenase deficiency in a child which was latent through his childhood, triggering a hemolytic episode induced by Leptospira infection. In a patient with acute hemolysis, presenting with severe epigastric pain, one should therefore be aware of the possibility of the occurrence of pancreatitis.
Pediatric tracheostomy decannulation
Authors: Prem Kumar P , Somashekhar Abhilasha , Basavaraja Gangasamudra Veerappa , Sanjay K. S. , Fathima Afshan , Baskar Praveen
Published: January 2023

Background:

Advances in neonatal and pediatric intensive care have increased the number of children who survive with disabilities. The management of the tracheostomized child is a complex and demanding assignment as they have higher rates of complications. Ideally, the decannulation process should proceed once the child no longer requires mechanical ventilation and the underlying pathology has resolved or been reversed. This study highlights our experience in managing pediatric tracheostomy decannulation at a tertiary care center.

Subjects and Methods:

This was a single-center, prospective study conducted at the tertiary care pediatric hospital for a period of 1 year. Children with tracheostomy in situ who got admitted for laryngotracheobronchoscopy and decannulation were included.

Results:

Indication of tracheostomy was broadly divided into reasons causing upper airway obstruction and those requiring prolonged intubation. It showed that 82% were due to prolonged intubation, in which 85.3% were due to neurological reasons. The success rate for decannulation was 97%. Age of child, duration of intubation, posttracheostomy period, and type of tracheostomy tube had no significant correlation with outcome of tracheostomy decannulation.

Conclusions:

Resolution of primary indication for tracheostomy is required before planning of tracheotomy decannulation. Bronchoscopic airway evaluation and decannulation trial in operation theater is needed for successful decannulation. There was no impact of age, duration of intubation, posttracheostomy period, and type of tracheostomy tube on the outcome of tracheostomy decannulation.
Necrotizing fasciitis complicating perforated Meckel's diverticulum in a patient with acute lymphoblastic leukemia relapse
Authors: Gupta Rahul , Chaudhary Ruchi , Mathur Abhinav , Mangal Kalpana , Shukla Arvind K , Bhandari Anu , Jain Rakesh K , Garg Kapil
Published: January 2023

The occurrence of necrotizing fasciitis in children with acute lymphoblastic leukemia (ALL) has been reported with malignancies during granulocytopenic episodes from chemotherapy. Perforation of Meckel's diverticulum in children with leukemia is very rare. Only one case has been reported in the literature till now. A 10-year-old male presented with acute abdomen and was diagnosed with perforation peritonitis due to a perforated Meckel diverticulum receiving chemotherapy for relapse of B-cell ALL. In addition, the patient was a known case of celiac disease. Intraoperatively, due to the hemodynamic instability and thrombocytopenia, it was decided to perform a resection of the ileum bearing the pathology with a double-barrel ileostomy. He developed necrotizing fasciitis of the anterior abdominal wall due to Group A streptococci and overwhelming Gram-positive sepsis. The patient was managed comprehensively with multiple platelets concentrates, fasciotomy of the abdominal wall, and multiple debridements under the cover of broad-spectrum antibiotics. Histopathology of the resected Meckel's diverticulum showed ectopic gastric mucosa. Two months later, split-thickness skin grafting was performed. Early diagnosis and prompt surgical management may prevent mortality associated with both the delayed presentation of bowel perforation and necrotizing fasciitis in ALL patients.
Pitfalls in clinical genetics
Authors: Chin Hui-Lin , Goh Denise Li Meng
Published: January 2023

With the increasing availability of genetic tests, more doctors are offering and ordering such tests for their patients. Ordering a genetic test appears to be a simple process of filling in paperwork, drawing 3 mL of blood in an ethylenediaminetetraacetic acid tube and receiving a test report. This is identical to sending off a full blood count. However, it is far more complex than that. There are many potential pitfalls, as shown by the increasing number of complaints and lawsuits filed against doctors and allied health staff. Furthermore, clinical genetics involves more than just ordering tests; in fact, focusing on genetic tests alone is a potential pitfall. In this review, we discuss the common pitfalls in clinical genetics and how doctors can avoid these pitfalls to ensure patient safety and to safeguard their practice.
Genetics in prenatal diagnosis
Authors: Lim Karen Mei Xian , Mahyuddin Aniza Puteri , Gosavi Arundhati Tushar , Choolani Mahesh
Published: January 2023

The options for prenatal genetic testing have evolved rapidly in the past decade, and advances in sequencing technology now allow genetic diagnoses to be made down to the single-base-pair level, even before the birth of the child. This offers women the opportunity to obtain information regarding the foetus, thereby empowering them to make informed decisions about their pregnancy. As genetic testing becomes increasingly available to women, clinician knowledge and awareness of the options available to women is of great importance. Additionally, comprehensive pretest and posttest genetic counselling about the advantages, pitfalls and limitations of genetic testing should be provided to all women. This review article aims to cover the range of genetic tests currently available in prenatal screening and diagnosis, their current applications and limitations in clinical practice as well as what the future holds for prenatal genetics.
How data science and AI-based technologies impact genomics
Authors: Lin Jing , Ngiam Kee Yuan
Published: January 2023

Advancements in high-throughput sequencing have yielded vast amounts of genomic data, which are studied using genome-wide association study (GWAS)/phenome-wide association study (PheWAS) methods to identify associations between the genotype and phenotype. The associated findings have contributed to pharmacogenomics and improved clinical decision support at the point of care in many healthcare systems. However, the accumulation of genomic data from sequencing and clinical data from electronic health records (EHRs) poses significant challenges for data scientists. Following the rise of artificial intelligence (AI) technology such as machine learning and deep learning, an increasing number of GWAS/PheWAS studies have successfully leveraged this technology to overcome the aforementioned challenges. In this review, we focus on the application of data science and AI technology in three areas, including risk prediction and identification of causal single-nucleotide polymorphisms, EHR-based phenotyping and CRISPR guide RNA design. Additionally, we highlight a few emerging AI technologies, such as transfer learning and multi-view learning, which will or have started to benefit genomic studies.
Missed diagnosis or misdiagnosis: common pitfalls in genetic testing
Authors: Shaw Tarryn , Fok Rose , Courtney Eliza , Li Shao-Tzu , Chiang Jianbang , Ngeow Joanne
Published: January 2023

Genetic testing has the power to identify individuals with increased predisposition to disease, allowing individuals the opportunity to make informed management, treatment and reproductive decisions. As genomic medicine continues to be integrated into aspects of everyday patient care and the indications for genetic testing continue to expand, genetic services are increasingly being offered by non-genetic clinicians. The current complexities of genetic testing highlight the need to support and ensure non-genetic professionals are adequately equipped with the knowledge and skills to provide services. We describe a series of misdiagnosed/mismanaged cases, highlighting the common pitfalls in genetic testing to identify the knowledge gaps and where education and support is needed. We highlight that education focusing on differential diagnoses, test selection and result interpretation is needed. Collaboration and communication between genetic and non-genetic clinicians and integration of genetic counsellors into different medical settings are important. This will minimise the risks and maximise the benefits of genetic testing, ensuring adverse outcomes are mitigated.
Understanding cancer predisposition in Singapore: what’s next
Authors: Chiang Jianbang , Shaw Tarryn , Ngeow Joanne
Published: January 2023

Knowledge of an underlying genetic predisposition to cancer allows the use of personalised prognostic, preventive and therapeutic strategies for the patient and carries clinical implications for family members. Despite great progress, we identified six challenging areas in the management of patients with hereditary cancer predisposition syndromes and suggest recommendations to aid in their resolution. These include the potential for finding unexpected germline variants through somatic tumour testing, optimal risk management of patients with hereditary conditions involving moderate-penetrance genes, role of polygenic risk score in an under-represented Asian population, management of variants of uncertain significance, clinical trials in patients with germline pathogenic variants and technology in genetic counselling. Addressing these barriers will aid the next step forward in precision medicine in Singapore. All stakeholders in healthcare should be empowered with genetic knowledge to fully leverage the potential of novel genomic insights and implement them to provide better care for our patients.
A note on cyclic vectors in Dirichlet-type spaces in the unit ball of
Authors: Vavitsas Dimitrios
Published: January 2023

We characterize model polynomials that are cyclic in Dirichlet-type spaces in the unit ball of
$\mathbb C^n$
, and we give a sufficient capacity condition in order to identify noncyclic vectors.
Frugal digitization of analog video endoscopic medical records in a Kenyan rural medical center
Authors: Kirengo Thomas Onyango
Published: January 2023

Background: Digitization of healthcare data has led to widespread healthcare transformation. This has been enhanced by the availability of new technologies at lower costs. Video recording can improve the quality of care, provider skills, education, and patient follow-up. However, limitations such as the risk of litigation, patient privacy, and poor legal framework have curtailed adoption. Rural hospitals have older analog equipment due to limited financial resources. Objectives: This study aims to present an alternative low-cost option. Methods: We present an economical method of recording and digitizing endoscopic and laparoscopic procedures performed on analog video processing towers. We showcase a video of the step-by-step procedure that involves connecting a digital video home system (VHS) video recorder to an analog Olympus endoscopy machine (Model CV-100) and transferring media via a portable storage device to an electronic medical record database. Conclusion: Using simple home video recording devices provides a low-cost solution to creating digital records from analog video endoscopic machines. The technique, however, creates additional steps to the endoscopy process and the need for capacity building of the endoscopist. Patient consent forms should cover video creation. Medical centers should have a robust information management system to securely store and retrieve digitized video records.
Pattern of HER2 overexpression in urinary bladder carcinomas in Kano, Nigeria
Authors: Haruna Muhammad Sanusi , Atanda Akinfenwa Taoheed , Iliyasu Yawale
Published: January 2023

Background: The worldwide distribution of bladder cancer varies, conforming to differences in environmental and genetic risk factors. HER2 neu is overexpressed in many human cancers, including urinary bladder carcinomas. The aim of this study is therefore to evaluate the pattern of HER2 positivity, and correlate HER2 positivity of urinary bladder carcinomas with age, gender of patients, histological subtypes, and tumor grades. Methods: This is a 2-year retrospective study from January 2015 to December 2016. Patients’ clinicopathological information was extracted from their case folders and pathology reports. The histological subtyping using the WHO 2016 classification and grading was done and then reviewed by authors. HER2 scoring was done using the recommendations of the American Society of Clinical Oncology/College of American Pathologists. Results: Sixty cases of bladder cancer were diagnosed during the study period. HER2/neu positivity (3+) was observed in 24 (40%) of all the cases. Statistically significant association was observed between HER2 neu protein overexpression and increasing tumor grade (p≤ 0.001). Conclusion: This study recorded HER2 overexpression in 40% of study subjects. There is a statistically significant association between HER2 overexpression and increasing tumor grade.
Preoperative hormonal stimulation in hypospadias: a systematic review
Authors: Pramono Indrayudha , Siregar Safendra , Sibarani Jupiter
Published: January 2023

Introduction: Preoperative hormonal stimulation with testosterone or estrogen is an emerging treatment modality for hypospadias, which can potentially improve surgical outcomes and reduce the risk of complications. This review aims to evaluate the current knowledge on preoperative hormonal stimulation in hypospadias. Methods: This study was a combination of a systematic review followed by a meta-regression analysis performed on PubMed, Google Scholar, DOAJ, and Cochrane. The study included randomized controlled trials, prospective and retrospective cohort studies, and before-and-after studies with or without control. The search was performed in English and was limited to articles published between January 1, 2000, and December 31, 2020. Results: The database search yielded 188 articles, which were systematically eliminated, leaving 15 relevant articles. The analyzed articles showed that testosterone is the most commonly used hormonal treatment in hypospadias, followed by dihydrotestosterone (DHT) and estrogen. Testosterone may be given in topical, parenteral, or oral formulations, while DHT is most often used in topical form. Conclusions: Preoperative stimulation with testosterone or DHT is associated with increased penile length and glans circumference before surgery, which may ease the reconstruction process. In addition, testosterone and DHT increase the rate of neovascularization and reduce the risk of postoperative complications.
Mesenteric ischemia: a case of extrapulmonary presentation in COVID-19
Authors: Salpekar Radhika , Krishna Sunil
Published: January 2023

Coronavirus 2019 (COVID-19) is a predominantly respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It creates a hypercoagulable milieu, manifesting at varied extrapulmonary sites as pulmonary embolism, deep venous thrombosis, stroke, myocardial infarction, and mesenteric ischemia. The pathophysiology behind this hypercoagulability is still not entirely understood, although a heightened systemic inflammatory response to the virus is deemed responsible. We herein report a case of a 36-year-old healthy male who presented with an acute abdomen and was found to have extensive mesenteric and portal venous thrombosis with bowel gangrene. The patient underwent emergency exploration with ileal resection and end-ileostomy. The hypercoagulability panel was negative, but a postoperative chest radiograph revealed suspicious ground-glass opacities. Given the ongoing global COVID-19 pandemic, we considered testing for SARS-CoV-2. A positive test for SARS-CoV-2 led us to attribute the thrombotic event to COVID-19. With anticoagulation and supportive therapy, the patient went on to make a steady recovery. A non-specific clinical manifestation of COVID-19 necessitates considering mesenteric venous thrombosis as a differential diagnosis in patients with acute abdomen.
Seek and you shall find—retrieval of a retained fractured intravenous cannula by Z-plasty incision: a case report
Authors: Ezeah Ikechukwu , Nweke Michael Chukwugoziem , Adejumo Oluseyi Ademola , Junaid Oladimeji Adedeji , Ige Oluwole Olugbenga
Published: January 2023

Peripheral venous cannulation is a common invasive procedure. Fracture of an intravenous cannula is rare and an under-reported complication of peripheral venous cannulation. Embolization of the intravenous fragment into the central venous system is potentially fatal. Urgent surgical retrieval, which is performed through a transverse or longitudinal incision, is the treatment of choice. We herein present the use of Z-plasty incision for the retrieval of a retained fractured peripheral intravenous cannula in a 61-year-old Nigerian man on hemodialysis for chronic kidney disease. The major benefits of this innovation are facilitation of access for exploration and prevention of joint contracture.
A personhood-based theory and the death penalty: An appraisal of AE Chimakonam’s theory of right action
Authors: Bambale Zubairu Lawal
Published: January 2023

Until recently, there have only been what are considered to be moral beliefs/worldviews/cultural practices as moral justification for actions in African ethics. However, recent intellectual activities brought about the development of ethical theories that serve as frameworks for justifying actions as good/right or bad/wrong from an African perspective. Guided by the principles that are derivable from African values, norms and thought, the theories provide systematic, coherent and universal frameworks of moral justification in a way that beliefs or worldviews do not. In this paper, I look into one of the theories. Propounded by Amara Esther Chimakonam, the theory draws from the African normative idea of personhood that Ifeanyi Menkiti proposes. My aim is to show its weaknesses and strengths. I begin with the weaknesses by arguing that, among others, the theory is unsuccessful in adequately accommodating individual excellences, such as interests and rights that it promises to accommodate. I then move on to show its strength by demonstrating that it provides a plausible moral argument against the death penalty from an African perspective.
Bernard Matolino’s outline of the basis for a new Afro-communitarian democracy
Authors: Gwara Joyline
Published: January 2023

In this paper, I engage with Bernard Matolino’s proposal for a new Afro-communitarian democracy as presented in his works “An Outline of the basis of a new Afro-communitarian political theory”, “Afro-Communitarian Democracy” and “Consensus as Democracy in Africa”. In these works, Matolino proposes limited communitarianism, which he believes takes care of the challenges presented by majoritarian democracy, socialism, and consensus democracy. His main argument is that democracy is possible in Africa. But this democracy should not be understood as majoritarian, socialist or consensus since these other ideas have their foundation in Afro-communitarianism, which limits individual rights. Instead, democracy should be built on limited communitarianism, which does not diminish individual rights but provides an environment conducive to realizing individual privileges, potentials, and rights. I will go about my task by looking at how Matolino outlines the weaknesses of Afro-communitarianism and the democracy that it inspires. Secondly, I will look at his proposal for a new Afro-communitarian democracy, which he called limited communitarianism, by considering its strengths and weaknesses.
An outline of the basis for a new Afro-communitarian political theory of democracy
Authors: Matolino Bernard
Published: January 2023

No abstract
Bullying in secondary schools
Authors: Lodenyo Hudson A.
Published: January 2023

No abstract
Corrigendum: Sexual behaviour and uptake of modern contraceptives among adolescents in public secondary schools in Lagos State, Nigeria
Authors: Ojo Omobola Y. , Adeniran Adeyinka , Oluwole Esther O. , Olutoba Adebisi P. , Adewole Salahudeen R.
Published: January 2023

BACKGROUNDGlobally, more than 16 million adolescent girls give birth every year with additional 5 million abortions. Adolescent pregnancy has been associated with high maternal mortality rates in Nigeria. Therefore, this study was designed to assess sexual behaviour and contraceptive uptake among secondary school adolescents in an urban area in Nigeria.MATERIALS AND METHODSThe study was a descriptive cross-sectional study of students from twelve senior secondary schools in 2018. Respondents were interviewed using self-administered structured questionnaires. The questionnaire was pretested and analysis was done using SPSS version 17.0; descriptive data were presented as simple frequencies and percentages. The chi-square test was used for associations and the level of significance was set at p≤5%.RESULTSThe majority of the respondents (70.3 %) were within the age bracket of 13 to 16 years with a mean age of 15.95±1.43. Generally, there was 100% awareness of the methods of contraceptives by all, with 64.5% aware of condom usage as a method of contraception. The level of knowledge scored fairly (62.4%), and attitude was 48.9% amongst males and females who had responsibility for contraception. Peer pressure of 42.9% was stated as one of the major factors affecting the utilization of modern contraceptives.CONCLUSIONAwareness of contraception amongst adolescents was high. But with the level of knowledge identified, the government should ensure proper measures to promote sexual behaviour and uptake of contraception among adolescents in Nigeria.
Impact of water sources on Schistosomiasis transmission and urine indicators
Authors: Onosakponome E.O , Ezeanyagu O.C. , Ejinaka O.R , Obeta M.U , Agbalaka P.I
Published: January 2023

BACKGROUNDSchistosomiasis is a significant debilitating disease caused by Schistosoma species. Infection is acquired when people come into contact with fresh water infested with the larval forms (cercariae) of parasitic blood flukes, known as schistosomes. The study aimed to assess the impact of water sources on schistosomiasis transmission and potential urinary markers for diagnosis.METHODOLOGYIn this cross-sectional study, a total of 230 pupils were examined. Stool and urine samples were collected from each of them. Stool samples were analysed using the Formal-ether concentration method, and urine samples using the centrifugation sedimentation method and reagent strip.RESULTSThis study showed that out of 230 pupils examined, 7(3.0%) were infected with S. mansoni, and 4(1.7%) were infected with S. haematobium. Prevalence of Schistosomiasis according to a source of water contact; revealed a significant difference in infection level based on the source of drinking water at (P<0.05). Those whose source was Dam/River had the highest prevalence, 4(25.0%), followed by stream water 4(10.0%), and the least was well water 2(3.30%). The ability of microhaematuria and proteinuria to accurately identify all those with the disease (sensitivity) was 25.0% and 75.0%, respectively. In comparison, the ability to sort out all those without the disease (specificity) was 97.35% and 96.46%, respectively.CONCLUSIONThe presence of Schistosomiasis among school children is linked to the water sources. Hence, water treatment intervention must reduce the risk of Schistosomiasis among pupils in Kisayhip, Bassa Local Government Area, Plateau State.
Study of D-dimer, CRP & ferritin status as independent risk factors for severity of the clinical aspects in patients with COVID-19 in Erbil, Iraq
Authors: Agha Nabaz Fisal Shakir , Rezaei Siyamak Asri , Al-khayat Zakarea Abdullah Yaseen , Abdulrahman Barzan Kamal , Alharmni Kawthar Ibrahim Fatah , Agha Derin Nabaz Fisal
Published: January 2023

BACKGROUNDCoronavirus Disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory disease which can evolve into multi-organ failure (MOF), leading to death. Several biochemical alterations have been described in COVID-19 patients. This study aimed to look at the ratio of D-dimer, CRP (C- reactive protein), and ferritin as independent risk variables in COVID-19 illness patients in Erbil Governorate, Iraq.MATERIALS AND METHODSIn this retrospective data collection study, we aimed to determine the number of patients diagnosed with COVID-19 who were admitted to Rizgary and Komary hospitals. Moreover, we collected data, including demographic features and laboratory analysis results regarding: D-dimer, Ferritin and CRP(C- reactive protein) extracted from the patient's medical records. Patients were Erbil residents admitted to Rizgary & Komary educational hospital from 1st April to 1st November 2020, with a confirmed diagnosis of COVID-19 infection using SARS-CoV-2 viral nucleic acid using RT-PCR. CRP, D-dimer, and ferritin levels had been routinely measured on admission.RESULTSCRP, D-dimer, and ferritin levels were measured in 234 individuals (115 men and 119 women). The group aged 15-25 was the least afflicted, while the age group 45-55 had the most COVID-19 patients. The frequency of this disorder did not differ statistically significantly between men and women. According to a massive increase in CRP, men showed a far higher risk than women. In the research groups, there were no statistically significant differences in ferritin changes between males and females. In terms of D-dimer, there was no statistically significant difference between males and females in either of the studied groups.CONCLUSIONSHigher CRP levels, indicating a higher risk of disease and predicting and measuring the onset of the disease in the first few days, are mandatory in tracking COVID-19 disease.
Metabolic Profile as a Predictor of Ischaemic Stroke: The Experience of a Rural Hospital in Nigeria
Authors: Olugbemide Orebowale , Bankole Idowu , Alabi Adewumi , Dic-Ijiewere Mercy , Eregie Aihanuwa , Fasanmade Olufemi
Published: January 2023

BACKGROUNDThe metabolic profile which includes glycated haemoglobin, insulin resistance, pancreatic beta cell function and lipid profile is frequently deranged in acute ischaemic stroke. Stroke is a leading cause of death worldwide and an emerging cause of long-term disability and mortality in Africa. Our study aimed to determine the correlation between the metabolic profile and acute ischaemic stroke in a rural Hospital in Southern Nigeria.METHODOLOGYThis was a prospective cross-sectional study. Fifty consecutive first-ever ischaemic stroke patients presenting within 72 hours of stroke were matched for age and sex with 3 control groups (49 persons with type 2 diabetes and hypertension, 49 persons with hypertension only and 57 apparently healthy individuals). Blood samples were obtained from all participants to determine glycated haemoglobin, fasting lipid profile, fasting plasma glucose, fasting insulin and C-peptide and random plasma glucose (in stroke cases at presentation). Insulin resistance and pancreatic beta-cell function were determined using the Homeostatic Model Assessment (HOMA). Data were analysed by multivariate and univariate statistics.RESULTSOne hundred and two (49.8%) males and 103 (50.2%) females participated in the study. The overall mean age of the study participants was 61.6 ± 10.1 years. Compared with the control groups, predictors of acute ischaemic stroke were Fasting insulin (hyperinsulinaemia) [OR (95%CI) = 1.108 (1.043-1.178), p= 0.001], HOMA-β% [OR (95%CI) = 0.994 (0.990-1.001) p=0.006] and total cholesterol [OR (95%CI)= 0.009 (0.001-0.012) p=0.022].CONCLUSIONIn this study, hyperinsulinaemia, impaired beta-cell secretory function (HOMA-β) and elevated total cholesterol were found to be significant risk factors of ischaemic stroke. Hence, the need for regular screening to detect abnormal metabolic profiles and prompt treatment.