bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of the effects of bupivacaine combined with sugammadex on the duration of the nociceptive blockade in sciatic nerve blocks: a controlled, double-blind animal study
Authors: Tasargol Omer , Darbaz Isfendiyar , Ergene Osman , Zabitler Feride , Deniz Aziz , Kose Selin Guven , Kose Halil Cihan , Tulgar Serkan
Published: November 2022

Background: Animal and other experimental studies have demonstrated increased block time and quality when α- and β-cyclodextrin drugs are combined with local anesthetics. However, to our knowledge, no study has utilized γ-cyclodextrins in such a combination. In the present study, we used an animal model to evaluate the effects of different doses of the combined administration of γ-cyclodextrin (sugammadex) and bupivacaine on the duration of sciatic nerve blocks in rats. Methods: Sciatic nerve blocks were performed with a 0.20 ml mixture in all groups. For the non-experimental groups, this mixture consisted of 0.2 ml saline (Sham group), 0.2 ml sugammadex (Group S), or 0.16 ml bupivacaine 0.5% and 0.04 ml saline (Group B). For the experimental groups, 0.16 ml bupivacaine 0.5% was administered along with 0.01 ml sugammadex and 0.03 ml saline (Group BS1), 0.02 ml sugammadex and 0.02 ml saline (Group BS2), or 0.04 ml sugammadex (Group BS4). Proprioception, nociception, and motor function were evaluated until the sciatic block was completely reversed.Results: Motor, proprioceptive, and nociceptive blockades occurred within 5 min in all experimental groups. In Group BS4, the duration of the motor, proprioceptive, and nociceptive blockades was significantly increased compared with the other experimental groups. However, in Groups BS1 and BS2, only the duration of the nociceptive blockade was significantly increased.Conclusions: The combined administration of sugammadex and bupivacaine for sciatic nerve blocks in rats led to a significant increase in the duration of motor, proprioceptive, and nociceptive blockades.
Risk Factors and Occurrence of Chronic Kidney Disease Following Acute Kidney Injury in Children
Authors: Jan Muzafar , Ashraf Mohd , Baba Ruhail Ahmad , Bhat Sayar Ahmad
Published: November 2022

Background:

Chronic kidney disease (CKD) is an irreversible progressive condition with diverse etiologies among which acute kidney injury (AKI) is increasingly being recognized as an important one.

Methods:

This was a prospective observational study of pediatric intensive care unit (PICU) patients admitted with different etiologies, at a tertiary care hospital for children in Kashmir India, between October 2018 and September 2020. AKI was defined as an increase in absolute serum creatinine (SCr) ≥0.3 mg/dL or by a percentage increase in SCr 50% and/or by a decrease in urine output to <0.5 mL/kg/h for >6 hours (h). Besides analysis of AKI and associated PICU mortality, post-AKI patients after discharge were kept on follow-up for complete 1 year.

Results:

From 119 enrolled patients with AKI with no preexisting risk factors, 5.6% (n = 8/119) developed CKD. The AKI-associated mortality rate after 48 h of PICU stay was 13.4% (n = 16/119). At time of discharge from hospital, elevated blood pressure (BP) (n = 5/8) and subnephrotic proteinuria (n = 3/8) were the statistically significant sequels of AKI (P value <0.001) for progression to CKD. After 3 months of follow–up, elevated BP (n = 7/8) and subnephrotic proteinuria (n = 3/8) were significantly associated with progression to CKD at 1 year (P < 0.005).

Conclusions:

Occurrence of CKD after an attack of AKI was not uncommon and the risk of long-term consequences in the form of hypertension, proteinuria, and CKD is significant, which may be much higher than observed. It is prudent that all post-AKI PICU discharged patients must be monitored for the long-term consequences of AKI.
A Study of Rhino-Orbito-Cerebral Mucormycosis with COVID-19
Authors: Kumar Surendra , Kumar Harish , Mali Manoj , Meena Babu Lal
Published: November 2022

Background:

Mucormycosis is a life-threatening fungal disease in immunocompromised patients. There has been increase in the number of mucormycosis associated with COVID-19 patients in second wave. Now country battle with both COVID-19 and mucormycosis. An invasive mucormycosis infection has been a significant burden in India after COVID-19. It has been recently emerged a notifiable disease by the Rajasthan government. Our aim is to develop awareness regarding the importance of early detection and treatment of mucormycosis with COVID-19 and reduce the morbidity and mortality.

Materials and Methods:

This is a Prospective longitudinal study including 34 patients diagnosed with acute invasive fungal infection by contrast enhancement magnetic resonance imaging studies of paranasal, orbit and brain or nasal biopsy for KOH/culture. Diagnosis is made through routine blood tests, biopsy, and radiological imaging. The patients taken for the study were COVID-19 reverse transcription-polymerase chain reaction positive or recent post COVID-19 (within 15 days) or symptoms of COVID-19 with bilateral pneumonitis. The study was conducted with 34 patients admitted to the department of medicine with mucormycosis within a month may 2021.

Results:

A total of 34 patients with a mean age of 50.92 years old and male female ratio 24/10 (70.5/29.41) were included in this study. The most common comorbidity was diabetes mellitus (23 patients 67.64%). Nine patients were newly diagnosed or recent onset of diabetes with or after COVID-19 infection. Twenty-four (70.58%) patients were COVID-19 positive or recent (within 15 days) history of COVID-19 positive. Seven (20.58) patients had the history of steroid as a treatment during COVID-19 and 5 (14.70) patients was on oxygen inhalation. One (2.94%) patient was fully vaccinated, and 5 (14.70) patients had the history of steam inhalation. The most common involvement was naso-orbital mucormycosis found in 28 patients (82.35%) followed by nasal-and orbital 26 (76.47) and 18 (52.94), respectively. Naso-Orbito-Cerebral was seen in 16 (47.05) patients. The more common reported symptoms and signs were headache (76.47), facial numbness (64.70), Nasal discharge (52.94), and ophthalmoplegia (52.94). Cranial nerve involvement was seen in 10 patients (facial palsy in 8 patients and bulbar palsy in 2 patients). Total mortality was 7 (7/34 20.58%).

Conclusion:

COVID-19 infection associated with the wide range of invasive mucormycosis. Early diagnosis and Clinical suspicion of acute invasive fungal sinusitis among COVID-19 patients is essential for better outcomes and higher survival.
Eosinophilic Gastroenteritis
Authors: Janardhanan Sandheep , James Allwin , Palaniappan Alagammai , Lukose Jibin , Narasimhan Mohan , Ardhanari Ramesh
Published: November 2022

Eosinophilic gastroenteritis (EGE) is a rare disease with a myriad of presentations. In this case series of four patients from South India, we describe three classical manifestations of the disease (mucosal, muscular, and serosal). Two of them had obstructive jaundice as a presenting complaint due to duodenal obstruction, whereas one had massive upper gastrointestinal bleed. There are very few case series regarding this disease from India. Its presentation as hemetemesis and obstructive jaundice is also very rare, with only few such case reports reported till now.
Spectrum of Magnetic Resonance Abnormalities in Leigh Syndrome with Emphasis on Correlation of Diffusion-Weighted Imaging Findings with Clinical Presentation
Authors: Kakkar Chandan , Gupta Seema , Kakkar Shruti , Gupta Kamini , Saggar Kavita
Published: November 2022

Background:

Leigh syndrome (LS) is a progressive neurodegenerative disorder of infancy/early childhood secondary to mitochondrial dysfunction. Imaging plays a pivotal role in the diagnosis of LS with certain typical magnetic resonance imaging (MRI) findings considered as a part of diagnostic criteria. We appraised various MRI findings on conventional MRI sequences and also assessed potential correlation between diffusion abnormalities and patient's clinical presentation.

Aims:

Our aim was to describe various patterns of central nervous system involvement in LS and to assess the correlation of diffusion-weighted imaging abnormalities with clinical presentation.

Settings and Design:

The design of the study was retrospective comprising 8 children with LS who had MRI between years 2014 and 2019.

Subjects and Methods:

Eight children between the age group of 4 months 8 years with LS based on clinical presentation, elevated lactate levels in CSF/Blood, and typical MRI findings were included in the study.

Results and Conclusions:

Brainstem was involved all (100%) patients while basal ganglia was affected in 5 (62.5%) children. Cerebral white matter involvement was present in 3 (37.5%) children, cerebellar in 2 (25%) children while spinal, corpus callosum, and thalamic involvement were observed in one (12.5%) patient each. Diffusion restriction was observed in 6 children, all of them presented with altered sensorium. Conventional MRI serves as an excellent tool for the diagnosis of LS in children with clinical suspicion. Acute encephalopathy frequently presents with diffusion restriction corresponding to active lesions. Hence, diffusion restriction on MRI predicts the activity of lesions in patients with LS.
The Evaluation of Serum Lipid Profile in Chronic Hepatitis B Patients at a Tertiary Care Centre in Western India
Authors: Meena Durga Shankar , Kumar Deepak , Garg Mahendra Kumar , Meena Mahadev , Seju Bharat , Bohra Gopal Krishana , Midha Naresh Kumar , Banerjee Mithu
Published: November 2022

Introduction:

Hepatitis B virus (HBV) is known as a metabolovirus due to its impact on lipid and glucose metabolism in the liver. Previous literature showed a trend of hypolipidemia and reduced risk of metabolic syndrome in hepatitis B surface antigen-positive patients. However, data from the Indian population are lacking. We evaluate the relation of lipid profile with HBV infection and severity of liver disease.

Materials and Methods:

This was an observational cross-sectional study in which 50 patients with chronic hepatitis B and 43 anthropometrically matched seronegative controls were enrolled. Demographical, clinical, and laboratory data including lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol [TC]) were collected. Seropositive patients were categorized based on prognostic models (model for end-stage liver disease [MELD] and Child-Pugh score) for further analysis.

Results:

Our study revealed significant low levels of serum TC, HDL, and LDL cholesterol in hepatitis B patients compared to seronegative controls (133.06 vs. 162.39, 35.56 vs. 43.65, and 76.62 vs. 99.95 mg/dl respectively,P< 0.05). The patients with high MELD and Child-Pugh score were associated with hypolipidemia. Significant low levels of LDL and TC were observed in Child-Pugh class C in comparison to class A (94.8 vs. 149.2 and 50.6 vs. 87.9 mg/dl respectively,P< 0.05).

Conclusions:

A significant reduction in various lipid parameters was seen with chronic hepatitis B. Furthermore, prognostic score (high MELD and Child-Pugh score) were associated with hypolipidemia.
Detection of Heteroresistant Vancomycin-Intermediate Staphylococcus aureus among Methicillin-Resistant Staphylococcus aureus
Authors: Chaudhary Bajarangi Lal , Bisht Dakshina , Faujdar Sameer Singh
Published: November 2022

Background:

The testing of heteroresistance vancomycin-intermediate Staphylococcus aureus (hVISA) by the population analysis profile-area under the curve (PAP-AUC) is tedious and laborious. The goal of this study was to determine the prevalence of hVISA among methicillin-resistant S. aureus (MRSA) and compare two screening tests: brain heart infusion agar with vancomycin 4 mg/L (BHIV4) and macromethod E-test (MET) with PAP-AUC as the gold standard.

Materials and Methods:

Antibiotic sensitivity test and detection of MRSA were performed according to the CLSI guidelines. PAP-AUC, BHIV4, and MET were used to detect hVISA.

Results:

A total of 288 MRSA isolates were tested for hVISA, with 48 (16.66%) being detected by PAP-AUC. With PAP-AUC, BHIV4's sensitivity, specificity, positive predictive value, and negative predictive value were 70.83%, 96.66%, 80.95%, and 94.3%, respectively. The majority of hVISA isolates were found in the vancomycin minimum inhibitory concentration range 1–2 mg/L.

Conclusions:

hVISA was found to be 16.6% in this investigation. When compared to MET, BHIV4 had a higher sensitivity, and teicoplanin and linezolid were found to be the most effective drug against hVISA.
Phenotypic Detection of Biofilm Formation in Clinical Isolates of Methicillin-Resistant Staphylococcus aureus
Authors: Malik Nitisha , Bisht Dakshina , Aggarwal Juhi , Rawat Ashutosh
Published: November 2022

Background:

Staphylococcus aureus is one of the common pathogens which causes mild-to-severe diseases. Moreover, its ability to produce biofilm along with drug resistance makes it more notorious and difficult to treat; therefore, early biofilm detection can help in better management of diseases caused by methicillin-resistant S. aureus (MRSA).

Materials and Methods:

All clinically isolated S. aureus were screened for their antibiotic susceptibility pattern followed by MRSA status by cefoxitin disk-diffusion method. Evaluation of biofilm-producing nature of biofilm was accessed by tissue culture plate (TCP), tube adhesion (TA), and Congo red agar (CRA) methods.

Results:

Of all S. aureus isolates, 57% had MRSA status. TCP method showed that 68% of MRSA were biofilm producers. TA method showed 55% and CRA method showed 46% biofilm production.

Conclusion:

Early detection of MRSA and biofilm could be very beneficial to control S. aureus infection. Of all three biofilm detection methods, TCP method was effective in detecting biofilm, followed by TA and CRA methods.
Post-COVID-19 Infection
Authors: Singh Harpal , Kaur Kanwardeep , Mittal Sheenab , Kaur Ivanpreet , Mittal Manisha , Kundal Ramesh K
Published: November 2022

Background:

Mucormycosis is an opportunistic infection which has increased in the recent times of upsurge of cases of covid 19. Secondary infection by mucormycosis is noticed in individuals with low immune status, patients on steroid and oxygen therapy. Aims and Objectives: The aim was to analyse mucormycosis cases post covid19 as per age, gender, site of involvement, hospitalization status, site involvement and treatment outcome of patients.

Materials and Methods:

A retrospective study was conducted on specimens received in the Department of Pathology, over a period of 1 year in which 29 cases of mucormycosis were included. Specimens received in the laboratory were fixed in 10% formalin and submitted to detailed gross examination. Proper orientation in eye exenteration specimens and meticulous examination of the debridement specimens was done along with submission of representative sections in all the cases. Sections were then stained with H and E stain and special stain i.e., PAS and examined microscopically.

Results:

In this study, 29 patients over a period of 1 year are presented from a tertiary care center out of which 19 are males and 10 females, 82.75% patients with mucormycosis are covid 19 positive. Nasal cavity and maxillary sinus are most common sites involved. Survival rate in these patients is high due to early diagnosis and treatment.

Conclusion:

Hence, the present study emphasizes on the high incidence of mucormycosis in Covid 19 patients with predisposing factors mainly immunocompromised status, hospitalized patients. To prevent the occurrence of mucormycosis, early identification and further investigation of this fungus will significantly reduce the severity of the disease and mortality rate in Covid 19 affected patients.
Decreased Serum B12 Due To Antidiabetic Drugs
Authors: Kanchi Divya , Rajendran Kannan , Vijayan Vinaya , Dutta Malini , Ramreddy B.
Published: November 2022

Background:

The first-line medication, metformin, can decrease hepatic gluconeogenesis and improve insulin sensitivity. Metformin inhibits the mitochondrial respiratory chain at the molecular level, which leads to an increase in adenosine monophosphate-activated protein kinase, which enhances insulin sensitivity. With no known renal or hepatic disease, updated recommendations recommend using metformin as a first-line glucose-lowering medication in conjunction with lifestyle changes. Metformin has been demonstrated to lower vitamin B12 levels. Vitamin B12 is a vitamin that is necessary for proper hemopoietic, neurocognitive, and cardiovascular function. Vitamin B12 deficiency has been shown to be quite common in people with type 2 diabetes mellitus, both biochemically and clinically. Diabetes is thought to be an oxidative stress and chronic inflammatory disease. Vitamin B-12 is an antioxidant, as per recent research, and a low vitamin B-12 level might be a contributing factor to oxidative stress, particularly in diabetic patients. Vitamin B-12 is an antioxidant and anti-inflammatory substance that may influence oxidative stress responses, including inflammatory reactions. As a result, the goal of this research was to study at possible associations between vitamin B-12 status and inflammation in Type 2 diabetes mellitus who are on metformin and on metformin with other associated anti-diabetic drugs.

Aims and Objectives:

In our study we tried to see the association between serum B12 levels and proinflammatory cytokines which lead to many macrovascular complications like cardiovascular diseases, renal failure etc.

Materials and Methods:

The present study recruited 500 participants between 30 and 65 years of age. patient pool who has been recently diagnosed as type 2 diabetics on metformin usage for more than 12 to 18 months. The study design was divided into 3 groups: A, B, and C. Group A consisted of 200 subjects with type 2 diabetes only on metformin with a daily dosage of 500 mg/day, and Group B consisted of 200 subjects with type 2 diabetes who were on both metformin with a daily dosage of 500 mg/day and other anti-diabetic drugs of around 2 mg/day. Both groups A and B had no other complications from diabetes. Group C included controls, consisting of 100 healthy individuals with no history of diabetes.

Results:

The percentages of Serum B12, in both male and female groups were significantly decreased in cases and consequently, inflammatory markers like leptin, IL-6, hsCRP, TNF-α were significantly increased who were on metformin than who were on metformin and other associated drug group.

Conclusions:

Findings from this study clearly indicates the link between decrease in B12 and progression of inflammation. the role of metformin in vitB12 deficiency levels, uncontrolled glucose levels, and chronic inflammatory responses in T2DM patients, gradually leading to the dire consequences of B12 deficiency.
Association of Anxiety with Oral Health-Related Quality of Life Among Kashmiri Residents
Authors: Bashir Sana , Menon Ipseeta , Gupta Ritu , Sharma Anubhav , Arora Vikram , Rohatgi Lavanya
Published: November 2022

Introduction:

Along with other healthcare indicators, psychological well-being of the population worldwide has been greatly affected after outbreak of covid-19. Almost all states in India including Jammu and Kashmir suffered during COVID-19. Thus this study was planned to determine the association of anxiety and its impact on oral health-related quality of life (14-item Oral Health Impact Profile [OHIP-14]) among residents of four districts of Jammu and Kashmir state during COVID-19.

Materials and Methods:

A self-administered questionnaire consisting of OHIP-14 along with a 7-item Generalized Anxiety Disorder Scale (GAD-7 Scale) was distributed among the residents of Kashmir via e-mails, WhatsApp groups, and Facebook using Google Forms.

Results:

Majority of the participants were males (53%) over 18 years of age. The most frequently experienced problems were discomfort during eating food (75%) and physical pain in the mouth such as aching in the mouth (60%). A highly statistically significant negative correlation was found between OHIP-14 and GAD among painful aching in the mouth (−0.044) (0.154**) **p<0.001. Half (50%) of the participants reported minimal anxiety.

Conclusion:

There is an unmet and immediate need to escalate the mental health services in Jammu and Kashmir state of India, which consisted of community participation, awareness programs, and mental health rehabilitation services.
Cannabinoids
Authors: Lalsare Sulabha Sambhaji
Published: November 2022

Cannabidiol industrialization is expected to reach $20 billion in sales by 2024 due to a sudden rise in scientific interest in marijuana (cannabis) and its therapeutic potential. Cannabis has been utilized for thousands of years in both medicine and science. Additionally, it has been noted that marijuana's therapeutic use is expanding steadily, and the entire plant can be used to diagnose a number of medical conditions. This is because the human endocannabinoid system has been thoroughly investigated, as well as the molecular structures of tetrahydrocannabinol (THC) and cannabidiol (CBD). This review article aims to go through the aspects of cannabis, such as legality, pharmacokinetic parameters, mode of action, and botanical characteristics. The review focuses on the medical applications of cannabis, including the pharmacology of cannabis and cannabinoids, current legal issues, and cannabidiol effect on diverse biological targets. The evidence presented herein in humans on the diagnostic utility and risks of cannabis is focused on unprocessed, botanical cannabis rather than isolated cannabinoids, of which only a few are therapeutically approved. Many studies are ongoing to evaluate the role of cannabis in the diagnosis of various disorders. Different cannabis-based products can cause various side effects. In the last half-century, excellent knowledge has been gained about the effects of marijuana and its cannabinoid components in nonmedical and medical settings. The hallucinogenic cannabinoid delta-9-THC was discovered in the marijuana herb in 1964. Marijuana and synthetic cannabinoids have become the world's most extensively used illicit substances, and most countries classify them as drugs of abuse. After alcohol and cigarettes, marijuana is the third most popular drug in the United States. Marijuana is used to treat generalized anxiety disorder, chronic back pain, seizures, depression, and posttraumatic stress disorder. The SwissADME online tool for CBD was used to identify the 100 most likely targets from the biological system. CBD's ability to combat these targets has been reported in a number of studies. It was found that maintaining legitimacy in the use of marijuana is challenging when considering legality, therapeutic potential, and the likelihood of misuse.
Sharp superlevel set estimates for small cap decouplings of the parabola
Authors: Fu Yuqiu , Guth Larry , Maldague Dominique
Published: November 2022

We prove sharp bounds for the size of superlevel sets

\{x \in \mathbb{R}^2\colon |f(x)| >\alpha\}

, where

\alpha>0

and

f\colon\mathbb{R}^2\to\mathbb{C}

is a Schwartz function with Fourier transform supported in an

R^{-1}

-neighborhood of the truncated parabola

\mathbb{P}^1

. These estimates imply the small cap decoupling theorem for

\mathbb{P}^1

of Demeter, Guth, and Wang (2020) and the canonical decoupling theorem for

\mathbb{P}^1

of Bourgain and Demeter (2015). New

(\ell^q,L^p)

small cap decoupling inequalities also follow from our sharp level set estimates.
Determinants of male partner involvement in antenatal care services at Kangundo Sub-County Hospital in Kenya
Authors: K Muia Pauline , W Mbuthia Grace , K Mugambi Rosemary
Published: November 2022

Background: Male partner involvement in antenatal care services is aimed at improving maternal health outcomes since men are important persons who play great roles at the family level.

Objective: To assess the level and determinants of male partner involvement in antenatal care at Kangundo Sub-County hospital in Kenya.

Methods: The study used analytical cross-sectional study method and was carried out in the maternal and child health clinic of Kangundo Sub-County hospital. Two hundred pregnant women at any gestational age, accompanied or not, seeking antenatal care services during the study period formed the study population. Simple random sampling technique was used to achieve a sample size of 132 participants. The data was then analyzed using the statistical package for social science (SPSS) version 20.0.

Results: The study revealed a low-level male partner involvement of 34.1%. Business as male partners’ occupation (OR = 2, 95% CI (0.314 – 12.729), and distance from the health facility; living 4km from the facility (OR = 5.225, 95%CI (1.319 – 20.705) and more than 5km from the facility (OR = 3.520, 95% CI (0.941 – 13.174) were significantly associated with male partnerinvolvement.

Conclusion: The factors contributing to low male partner involvement included: men being busy at work and the distance covered to reach the health facility.

Keywords: Antenatal care services; male partner involvement; male partner accompaniment.
Drotaverine to shorten the duration of labour in primigravidas: a randomised, double-blind, placebo-controlled trial
Authors: Chidiebele Ikeotuonye Arinze , Johannes Umeora Odidika , Ifunanya Nwafor Johnbosco , Omuye Ojumah Bonaventure , Cecilia Ekwunife Ifeoma , Bonaventure Dimejesi Ikechukwu
Published: November 2022

Background: Drotaverine, a spasmolytic, has been found to have potential to achieve a reduction in the duration of labour and prevent prolonged labour.

Objective: To compare the effects of intravenous drotaverine hydrochloride with placebo for shortening the duration of active phase of labour in primigravidas.

Methods: A double-blind, placebo-controlled randomized trial of 246 primigravidas in active phase of labour at term was conducted. They were randomly (1:1 ratio) administered intravenous 2 ml (40mg) of drotaverine hydrochloride or 2 ml of Vitamin B complex as placebo. The primary outcome measure was the duration of active phase of labour. The secondary outcome measures were cervical dilatation rate, oxytocin augmentation rate, incidence of prolonged labour, labour pain scores, mode of delivery, maternal and neonatal outcomes.

Results: The mean duration of active phase of labour (hour) was significantly lower in the drotaverine group compared to the control (drotaverine; 6.22 ± 2.41 vs placebo; 8.33 ± 3.56; p <0.001). Also, the cervical dilatation rate (cm/hr) was significantly faster in the drotaverine arm (drotaverine; 1.68 ± 1.02 versus placebo; 1.06 ± 0.53, p <0.001). There was a significantly higher probability of faster delivery among women who were given drotaverine (log-rank test, p < 0.001). The oxytocin augmentation rate, incidence of prolonged labour, labour pain scores, mode of delivery, maternal and neonatal outcomes were not significantly different among the groups.

Conclusions: Drotaverine hydrochloride is effective in shortening the duration of active phase of labour without adverse maternal and neonatal outcomes. However, more evidence is needed to explore its role in active phase of labour among primigravid women. Trial registration number: PACTR201810902005232.

Keywords: Drotaverine; duration of active phase of labour; primigravidas; placebo; shortening.
Association of ATM, CDH1 and TP53 genes polymorphisms with familial breast cancer in patients of Khyber Pakhtunkhwa, Pakistan
Authors: Rahim Abdur , Zakiullah  , Jan Asif , Ali Johar , Khuda Fazli , Muhammad Basir , Khan Hamayun , Shah Hussain , Akbar Rani
Published: November 2022

Background: Genetic studies play a significant role in understanding the underlying risk factors of breast cancer. Polymorphism in the tumor suppressor gene TP 53, CDH1 and ATM genes are found to increase susceptibility for breast cancer globally.

Objective: This study aimed to identify/analyze the contribution of genetic polymorphisms in the breast cancer candidate genes ATM, TP53 and CDH1 that may be associated with familial breast cancer risk in the Khyber Pakhtunkhwa population.

Subjects and Methods: In the present case-control study, Whole Exome Sequencing (WES) of the 100 breast cancer patients and 100 ethnic controls were performed for the selected genes in the target population.

Results: Of the studied variants rs3743674 of the CDH1 gene (crude P=0.014 and adjusted p=0.000) evident significant association with breast cancer in Pakistani Pashtun population. Whereas TP53rs1042522 (crude P=0.251 and adjusted P=0.851) and ATM rs659243 (crude p=0.256 and adjusted p=0.975) showed no or negative association with breast cancer in study population.Conclusion: The present study demonstrates that CDH1rs3743674 polymorphism is associated with elevated breast cancer risk in the Pashtun ethic population of Khyber Pakhtunkhwa.

Keywords: Breast cancer; TP53; CDH1; ATM; Risk Allele; Genotype.
Berberis lyceum root bark extract attenuates anticancer drugs induced neurotoxicityand cardiotoxicity in rats
Authors: Qurat-ul-Ain Sidra , Rukhsana Anwar , Isma Tariq Sahar , Kanwal Ashiq
Published: November 2022

Background: Traditionally, Berberis lyceum was extensively used for the treatment of several human diseases.

Objective: This study was undertaken to determine in vivo effects of Berberis lyceum root bark against doxorubicin-induced cardiotoxicity and cisplatin-induced neurotoxicity in Sprague Dawley rats.

Methods: A single dose of doxorubicin (20 mg/ kg i. p) and cisplatin (4mg/kg i.p) was used to induce cardiotoxicity and neurotoxicity, respectively. Berberis lyceum methanolic extract was given orally (200 and 400 mg/ kg) to toxicity-induced rats. The cardiac biomarkers i.e. serum aspartate aminotransferase, alanine transaminase, lactate dehydrogenase, creatine kinase and creatine kinase MB were analyzed in blood collected from cardiotoxic rats. The tissue oxidative stress markers included protein, glutathione s-transferase specific activity, catalase activity, total glutathione, and malondialdehyde levels were measured in cardiac and brain homogenate of the respective groups.

Results: Berberis lyceum methanolic extract has the potential to reduce the doxorubicin-induced cardiotoxicity and cisplatin-induced neurotoxicity significantly (*p<0.05) by reducing the serum markers and oxidative stress parameters. Histopathological analysis exhibited a marked improvement in the morphology of cardiac and brain tissues.

Conclusion: It is concluded that methanolic extract of Berberis lyceum root bark has the potential to protect and reverse anticancer drugs induced cardiotoxicity and neurotoxicity.

Keywords: Doxorubicin; Cisplatin; Berberis lyceum; Cardiotoxicity; Neurotoxicity; Antioxidant.
Histopathological pattern of Orbito-Ocular Lesions, a retrospective hospital-based study spanning 15 years
Authors: H Kayoma Dumebi , E Imasogie Dele
Published: November 2022

Background: Many previous studies on orbito-ocular lesions are skewed in favour of the neoplastic lesions in general and the malignant lesions in particular. This, therefore, creates a vacuum on the spectrum of these lesions, thus may result in problematic diagnostic bias by the ophthalmologist and pathologist.

Objective: To give the spectrum and relative frequencies of orbito-ocular biopsies and by extension orbito-ocular lesions/diseases at the University of Benin Teaching Hospital (UBTH).

Materials and Methods: A retrospective descriptive study of all cases of orbito-ocular biopsies with histopathologic diagnosis.

Results: There were 236 orbito-ocular biopsies. The male to female ratio was slightly in favour of the females. Orbito-ocular biopsies had a wide age range that spanned from the 1st to 10th decade, mean age in the 3rd decade (20-29years) and a peak age in the 1st decade (0-9 years). The neoplastic lesions were the prevalent indication for orbito-ocular biopsies (63.72%) while theconjunctiva (58.10%) was the most common site for orbito-ocular biopsies.

Conclusion: This study noted a wide array of orbito-ocular lesions for which biopsies were done for histopathological diagnosis. This we hope will in no small measure increase the diagnostic precision of the ophthalmologist and the pathologists in our own environment.

Keywords: Ophthalmic biopsies; ophthalmic lesions; malignant orbito-ocular tumours; benign orbito-ocular tumours; degenerative ophthalmic lesion.
Impact of exercise on renal function, oxidative stress, and systemic inflammation among patients with type 2 diabetic nephropathy
Authors: H Saiem Aldahr Mohamed , M Abd El-Kader Shehab
Published: November 2022

Background: Diabetic nephropathy (DN) is a prevalent microvascular diabetic complication all over the world.

Objective: This study was designed to measure oxidative stress, systemic inflammation and kidney function response to exercise training in patients with type 2 diabetic (T2DM) nephropathy.

Material and Methods: Eighty obese T2DM patients ( 50 males and 30 females), their body mass index (BMI) mean was 33.85±3.43 Kg/m2 and the mean of diabetes chronicity was 12.53±2.64 year participated in the present study and enrolled two groups; group I: received aerobic exercise training and group II: received no training intervention.

Results: The mean values of creatinine, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α) and malondialdehyde (MDA) were significantly decreased, while the mean values of interleukin-10 (IL-10), glutathione peroxidase (GPx) and glutathione (GSH) were significantly increased in group (A) after the aerobic exercise training, however the results of the control group were not significant. In addition, there were significant differences between both groups at the end of the study (P<0.05).

Conclusion: There is evidence that aerobic exercise training modulated oxidative stress and inflammatory cytokines and improved renal function among patients with diabetic nephropathy.

Keywords: Aerobic Exercise; Diabetic Nephropathy; Inflammatory Cytokines; Oxidative Stress.
Sexual coercion at sexual debut and associated factors among young females in rural areas of Boset District, Eastern Ethiopia: a mixed method study
Authors: Garoma Abeya Sileshi
Published: November 2022

Objectives: Assess the prevalence and associated factors of sexual coercion at sexual debut among young females in rural areas of Boset district, Oromia Region, Eastern Ethiopia.

Methods: Cross-sectional community based study design was conducted using both qualitative and quantitative data collection methods. A sample of 632 young females aged 10-24 years was taken from six rural Kebeles by systematic random samplingfor quantitative and data were collected using a pre-tested structured questionnaire. The collected data was analyzed using SPSS version 23. Principally Binary Logistic regression model was fitted. Moreover, eight focus group discussions targeting different groups were held andanalyzed thematically.

Results: The prevalence of sexual coercion at sexual debut was 36.5% (95%CI: 34.6%- 38.4%) among sexually active respondents. Married young female (AOR, 0.71; 95%CI: 0.42, 0.81), living away from their parents (AOR, 5.07; 95%CI: 1.07,24.01), age group of 15- 19 years (AOR, 0.19; 95%CI: 0. 06, 0.54), alcohol consumption (AOR, 2.44; 95%CI: 1.17, 5.08) and Khat chewing (AOR, 8.30; 95%CI: 1.89, 36.38) were factors predicting the likelihood of having sexual coercion at sexual debut.

Conclusion: Sexual coercion at sexual debut is a major public health problem among young females in the study community. The emerging program interventions need to take this problem into consideration.

Keywords: Coercion; sexual debut; rural; Ethiopia.
3d cranial reconstruction using titanium implant – a case report
Authors: Selvaraj Sunantha , Dorairaj Jayachandran , M Shivasankar
Published: November 2022

Cranioplasty is a neurosurgical procedure done to cover the defective or deficient skull bone. The cranial reconstruction rejuvenates the patient by protecting and restore intracranial structures and pressure thus improving the esthetic appearance. Thus improves the neurological and psychological wellbeing of the patient. The blending Advancement of computer technology in medical and dental science allowed the 3D reconstruction of several anatomical structures for various medical procedures by designing the custom-made implants.

Procedure: This case report describes the methodology used to design a custom-made cranial implant for a 38-year-old patient who had traumatic injury in the right temporosagital region of the skull caused by a road traffic accident . 3D reconstruction of the cranial vault was done using CAD designing and Selective laser melting (SLM) technology printing.

Discussion: The presicion of the prosthesis was good thereby the surgical time was reduced and eliminates any errors in operating theatre and successfully implanted. The patient’s esthetics was restores , allowing the patient to safely perform daily activities with full confidence.

Conclusion: The use of 3D reconstruction techniques in managing exhaustive surgeries aids to reduces the possibility of errors during surgery, precise and passive fit and provides better implant stability. Thus 3D printing technology has boomed its use in various field of medicine.

Keywords: Cranial implants; titanium; 3D Printing; Fused deposition modelling Printing; Selective laser melting (SLM) technology.
Aspergillus-specific IgM/IgG antibody serostatus of patients hospitalized with moderate-critical COVID-19 in Uganda
Authors: Bongomin Felix , Kwizera Richard , Mande Emmanuel , Melissa Aloyo Sharley , Achan Beatrice , Namusobya Martha , Goitom Sereke Senai , Batte Charles , Kiguli Sarah , Baruch Baluku Joseph , L Joloba Moses , J Kirenga Bruce
Published: November 2022

Invasive pulmonary aspergillosis is known to complicate the coronavirus diseases-2019 (COVID-19), especially those with criticalillness. We investigated the baseline anti-Aspergillus antibody serostatus of patients with moderate-critical COVID-19 hospitalizedat 3 COVID-19 Treatment Units in Uganda. All 46 tested patients, mean age 30, and 11% with underlying respiratorydisease had a negative serum anti-Aspergillus IgM/IgG antibody immunochromatographic test on day 3 (mean) of symptomonset (range 1-26), but follow up specimens to assess seroconversion were not available.

Keywords: Invasive pulmonary aspergillosis; COVID-19; critical illness; Uganda.
Severe liver injury affects the outcomes and length of hospital stay in children with community-acquired pneumonia
Authors: Zhang Lianyu , Zhao Shuai
Published: November 2022

Background: The present study was undertaken to evaluate the association between liver injury and clinical parameters, outcomes and length of stay (LOS) in hospital in children with community-acquired pneumonia (CAP).

Methods: Clinical data and laboratory indicators of 2,573 children with CAP were analyzed. The association between liver injury and clinical parameters, outcomes and LOS was then analyzed.

Results: Higher liver injury class was associated with higher incidence of severe CAP, comorbidities, hypoxia, requirement for mechanical ventilation, 30-day mortality and intensive care unit admission, and higher indicators of inflammation (C-reactive protein, procalcitonin and white blood cell count), longer LOS, faster respiratory rate and pulse rate, and lower age, serum albumin levels, monocyte and lymphocyte counts. Severe liver injury was identified as an independent factor for 30-day mortality and prolonged LOS in children with CAP. Higher liver injury class was associated with a lower cumulative survival rate (p=0.0004), and log-rank test for trend was used to demonstrate the association of each injury class with 30-day mortality (p=0.0002).

Conclusions: Several parameters were associated with liver injury in children with CAP. Severe liver injury was found to be an independent factor for 30-day mortality and LOS in children with CAP.

Keywords: Community-acquired pneumonia; liver injury; children; mortality; hospital length of stay.
Evaluating the level of disaster preparedness of Tunisian University Hospitals using the Hospital Safety Index: a nationwide cross-sectional study
Authors: Lamine Hamdi , Chebili Naoufel , Zedini Chekib
Published: November 2022

Background: Mid-way through the ‘Sendai Framework for Disaster Risk Reduction 2015-2030’, many nations are spending time, money and effort to enhance their level of preparedness facing disasters, on the other hand communities, countries and even continents are being left behind.

Objectives: This study was conducted aiming at evaluating the level of disaster preparedness and response of Tunisian University Hospitals.

Methods: This is a cross-sectional nationwide study conducted in Tunisia, from November 2020 to April 2021. Including 9 Tunisian University Hospitals and using the Hospital Safety Index. The data were analysed using the 'Module and safety index calculator'.

Results: This study showed that 7 out of the 9 University Hospitals were assigned the ‘B’ category of safety with overall safety indexes that ranges between 0.37 and 0.62. Also, 4 out of 9 University Hospitals had safety scores less than 0.20 regarding their emergency and disaster management.

Conclusions: This is the first study to evaluate disaster preparedness and response of university hospitals in Tunisia and in north Africa. It showed that the lack of knowledge, resources and willingness, are the most important issues that needs to be addressed in order to enhance the preparedness of Tunisian hospitals.

Keywords: Disaster preparedness; Hospital Safety Index; Tunisian University Hospitals; Scores.
Evaluation of collection development and management in selected university libraries in Ogun State, Nigeria
Authors: Awojobi Esther Abosede , Uthman Kikelomo Olubunmi
Published: November 2022

Collections of five university libraries in Ogun State, Nigeria were evaluated using SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis. Results showed that the libraries have strengths in having a collection development policy, users’ involvement in collection development, balanced, relevant and high-quality collections and up-to-date online databases. Lack of weeding policy and non - participation in the consortium are weaknesses in three libraries, opportunities include the use of other library resources, technology, open access resources, and acquisition through the Tertiary Education Trust Fund (Tetfund) in the government-owned institutions while the high cost of online subscriptions, other information services providers, inadequate funding of collection development in four libraries, reliance on Tetfund, gifts and exchange by public universities constitute threats. Findings further revealed no significant difference between collection development of public and private university libraries (t(74) = 0.20, p> 0.05). The study recommends the development of a weeding policy that must be adhered to as well as collaboration amongst libraries.
Information identification skills and research output of academic librarians in universities in South-South Geopolitical Zone of Nigeria
Authors: Ilevbare Godson Ehimiyein , Enang Uduak U. , Ukpanah Mercy E.
Published: November 2022

This study investigated the relationship between information identification skills and the research output of academic librarians in universities in the South-South Geopolitical Zone of Nigeria with a corresponding specific objective, research question, and research hypothesis. To effectively drive the study two theories were adopted. The theory of social-cultural learning for the independent variable (information identification skills), and the theory of self-efficacy for the dependent variable (research output of academic librarians). More so, a conceptual review of literature on information identification skills and research output was carried out and a specific empirical review of the literature with extrinsic similarity and dissimilarity to the study was also done. The study adopted the correlational research design as the research design while the study area was the South-South Geopolitical Zone of Nigeria. The population of the study comprised 252 academic librarians from 14 libraries and faculties. The census technique was used to select the research participants 252. The researcher-developed questionnaire entitled: “Information Identification Skills and the Research Output of Academic Librarians Questionnaire (IISROALQ)” was used to collect data while the reliability test results using the Cronbach Alpha formula in SPSS showed an average coefficient of .83 which signified that the instrument was reliable for the study. Data was collected from the various universities by the researchers and their trained assistants by following the requisite ethical procedures. The data collected was analysed using frequencies and percentages for the research question, while the test of hypothesis at ≤ 0.05 level of significance was carried out with the Chi-Square Test of Independence. The result showed that information identification skills have a positive significant relationship with the research output of academic librarians with p-value = 0.00, and Phi coefficient of 2.49 indicating a very large extent of a positive relationship. In conclusion, it was recommended that the National University commission should make proficient utilization of information literacy skills by academic librarians as part of the requirement to assess their suitability for performance within the scholarly communities. Also, the university management should give attention to constant information literacy skills programs to enhance the literacy skills of the academic staff to be able to produce quality and rich research output.
Information Communication Technology (ICT) facilities and information resource sharing activities in federal university libraries in North central, Nigeria
Authors: Eromosele Peace Osemudiamen , Ahmed Abdulganiy O. , Madu Evarest C.
Published: November 2022

The research investigated the impact of Information Communication Technology (ICT) Facilities on Information Resource Sharing Activities in Federal University Libraries In North Central, Nigeria. The study was guided by four objectives and one null hypothesis. A descriptive survey was used with the target population of 121 librarians in the seven federal university libraries in North central, Nigeria. The questionnaire was used in data collection. 121 copies of the questionnaire were administered 102 were filled, returned and found usable representing an 87.2% response rate. Percentage, Means and standard deviation were used in data analysis and Pearson Product moment correlation was used to test the null hypotheses. The study found that the factors restricting the usage of ICT for information resource sharing in federal university libraries in North central, Nigeria, were inadequate funding and lack of ICT infrastructure and connectivity. H01 showed that there was a relationship between ICT and information resource sharing in federal university libraries in North central, Nigeria. The study found that the factors restricting the usage of ICT for information resource sharing in federal university libraries in North central, Nigeria, were inadequate funding and ICT infrastructure and connectivity. The paper recommended amongst others that federal universities in North Central Nigeria should ensure that the funds allocated to the university library should be increased and also should endeavour to provide adequate ICT facilities that are lacking such as video conferencing and intranet to enhance information resource sharing activities.