bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of vitamin deficiency with the progression of anaemia
Authors: Hafiza Urwa , Ahmad Waheed , Hina Naz , Shoaib Akhtar M. , Saleem Khan M. , Muhammad Wajid
Published: July 2024

Vitamins are micronutrients that play a vital role in the body’s proper functioning and development. Furthermore, they are an essential requirement of the body for producing red blood cells (RBCs) and their growth. A particular quantity of micronutrients is mandatory for the regulation of body metabolism. Deficiency in vitamins leads to different types of anaemia in the body. Furthermore, deficiencies in both fat-soluble and water-soluble vitamins are linked to the destruction of RBCs. This review article was aimed at finding the correlation between the deficiency of vitamins and anaemia, with a major focus on the deficiency of vitamins B-9 and B-12 and their association with anaemia. In our deep observation of the literature, we found that the deficiency of vitamins causes iron malabsorption, haemoglobin (Hb) synthesis malfunctioning, impaired DNA synthesis, and a disturbed methylation cycle, while a disrupted erythropoiesis process and a reduction in the RBC’s production leads to anaemia. Interference in vitamin B-9 and vitamin B-12-associated chemical reactions causes deficiency and results in diminished DNA synthesis. Malabsorption of vitamins B-9 and B-12 is a major concern for anaemia, but other water and fat-soluble vitamins disrupt iron metabolism and interrupt the erythropoiesis process, which ultimately causes anaemia. There should be a balanced number of vitamins in the diet; otherwise, this will inhibit the production of RBCs. As Vitamin B-9 and B-12 deficiencies have been associated with a reduction in DNA synthesis, further study is required to discover how additional fat-soluble and water-soluble vitamins affect DNA synthesis.
Relationship between 25-Hydroxyvitamin D3 Levels with Pain Intensity and Duration of Labor Stages in Primiparous Women
Authors: Beni Mahsa Naderi , Mousavi Parvaneh , Latifi Seyed Mahmood , Beigi Marjan , Abbaspoor Zahra
Published: July 2024

Background:

Prolonged labor is associated with various maternal and neonatal complications. This study aims to investigate the relationship between 25-hydroxyvitamin D3 levels and pain intensity and duration of labor stages in primiparous women.

Materials and Methods:

This cross-sectional study was conducted in Iran from November 2021 to January 2022 and comprised primiparous women who were in active labor after a term pregnancy (37–42 weeks). Five milliliter of blood was taken from each subject and centrifuged for the measurement of vitamin D level using the enzyme-linked immunosorbent assay method. The High-Performance Liquid Chromatography (HLPC) method was used to measure 25-OH vitamin D. In addition, through history, examination, and investigations, the subjects were evaluated according to the pain intensity and duration of the first (active phase) and second stages of labor.

Results:

The results of the Pearson correlation test indicated a significant relationship between vitamin D and active phase duration (r = 0.64, p = 0.012), second stage duration (r = 0.73, p = 0.001), pain intensity of the active phase (r = 0.61, p = 0.022), and pain intensity of the second stage (r = 0.65, p = 0.026). According to the analysis of variance table, based on vitamin D, there were statistically significant differences between the groups in terms of the active phase duration, second stage duration, pain intensity of the active phase, and that of the second stage of labor (p < 0.05).

Conclusions:

Low levels of vitamin D may influence the progress of labor and increase the rate of prolonged labor.
Effectiveness of Logotherapy on the Organization-Based Self-Esteem and Job Satisfaction of Employed Midwives
Authors: Bazargan-Sabet Farahnaz , Alidousti Katayoun , Tashk Anahita , Yazdi-Feyzabadi Vahid , Ahmadi Atefeh
Published: July 2024

Background:

Midwives as one of the most effective members of the health systems play a key role in delivering health services to mothers and children who are vulnerable groups of the society. This research aimed to investigate the effect of Logotherapy on job satisfaction and Organization-Based Self-Esteem (OBSE) of employed midwives.

Materials and Methods:

This is a quasi-experimental study with the pretest and posttest design and a control group from all midwives employed in the public hospital of Rasht City in Iran. Fifty-six midwives fulfilling the inclusion criteria were selected and randomly divided into two groups of intervention and control. They filled job satisfaction, OBSE questionnaires, and demographic information checklist, and then, the intervention group attended Logotherapy for six sessions/90 minutes. Finally, both groups answered the instruments as posttest.

Results:

Results showed that the mean difference between OBSE (F 6,83 = 27, p < 0.05) and job satisfaction (t 2,62 = 27, p < 0.01) scores before and after the sessions in the intervention group was significantly more than the control group.

Conclusions:

Group Logotherapy increased job satisfaction and OBSE among midwives. It can be recommended for use in the clinical settings for healthcare providers.
Maternal Complications during Pregnancy and Risk Factors for Stunting
Authors: Maulina Rifzul , Qomaruddin Mochammad B. , Prasetyo Budi , Indawati Rachmah
Published: July 2024

Background:

Stunting can be prevented by early detection when the mother is pregnant. Early detection can be carried out by looking for risk factors of stunting during pregnancy so that interventions can be early detected. This study aims to assess complications during pregnancy (disease and infection) and risk factors associated with stunting.

Materials and Methods:

The type of research was observational analytic with a case-control design on 450 mothers who were selected with simple random sampling (150 mothers who have stunting babies aged 0–2 months and 300 mothers who have not stunting babies aged 0–2 months in Malang Regency, Indonesia. This study used secondary data by looking at medical records, namely, laboratory examinations in the mother’s book and cohort records at the public health center. This study was conducted from December 2021 to August 2022. Bivariate analysis with Chi-square and multivariate logistic regression was carried out to determine the variables that most influenced the incidence of stunting.

Results:

The results of multivariate analysis with logistic regression of maternal complications during pregnancy, which are a risk as a factor causing stunting, are Sexually Transmitted Infections (STIs) (Odds Ratio [OR]: 6.36; 95% Confidence Interval [CI]: 2.97–13.62), coronavirus disease 2019 (COVID-19) accompanied by pneumonia (OR: 5.12; 95% CI: 1.87–14.052), human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) (OR: 4.63; 95% CI: 1.10–19.59), hepatitis B (OR: 3.97; 95% CI: 1.253–12.565), pre-eclampsia (OR: 3.88; 95% CI: 1.81–8.30), and heart disease (OR: 3.373; 95% CI: 0.99–11.40).

Conclusions:

After recognizing the maternal factors that cause stunting, intervention should immediately be carried out on pregnant women with diseases (pre-eclampsia and heart disease) and infections (STI, COVID-19 + pneumonia, HIV/AIDS, and hepatitis B) to prevent stunting early.
Identifies Current Trends in Vaginal Birth after Cesarean Section in IRAN: A Qualitative Study
Authors: Khalajinia Zohre , Alipour Zahra
Published: July 2024

Background:

The growing prevalence of Cesarean Sections (CS), particularly repeated CS, is a major issue in contemporary midwifery. This study seeks to gain a comprehensive understanding of the experiences of pregnant women and specialists with vaginal delivery after CS, as well as the obstacles that may arise.

Materials and Methods:

From March 2020 to May 2021, 10 women, 12 midwives, and 8 obstetricians and obstetricians affiliated with Qom University of Medical Sciences were interviewed to investigate the experiences and challenges associated with Vaginal Birth After Cesarean section (VBAC). We used the content analysis method, and the sampling was purposive. Semi-structured interviews were conducted to collect data, which were then analyzed using qualitative content analysis based on conventional content analysis.

Results:

The results show that subcategories “individual aspects of VBAC” and “family-social aspects of VBAC” formed “positive aspects of VBAC.” Subcategories “self-efficacy” and “decision-making participation” formed the “empowerment for the woman.” Subcategories “technical team challenges” and “woman’s challenges” formed the main category of “upcoming challenges.”

Conclusions:

Positive relationships, choice-making ability, and self-confidence impact a woman’s decision to choose VBAC. Informing women of alternative delivery options after a CS and pursuing their dreams increases the likelihood of successful VBAC.
Aphallia with Anal Stenosis and Congenital Cyanotic Heart Disease: A Rare Case Report
Authors: Upreti Sheetal , Ahmad Md. Fahim , Malik Muneer Abas , Dogra Shivani
Published: July 2024

Aphallia, an extremely rare urogenital anomaly, presents complex challenges in diagnosis and management. This anomaly, often accompanied by other congenital malformations, necessitates multidisciplinary care, and careful consideration of treatment priorities. We describe a case of a neonate diagnosed with aphallia along with anal stenosis, bilateral hydroureteronephrosis, and tetralogy of Fallot. Despite prompt intervention plans, the neonate’s condition deteriorated rapidly, highlighting the urgency and complexity of managing aphallia-associated complications. While embryological insights offer some understanding of its etiology, the clinical manifestation of aphallia underscores the need for immediate supportive measures and thoughtful decision-making regarding gender assignment and surgical interventions. Beyond medical considerations, emotional and psychological support for families navigating treatment decisions is paramount.
Congenital Megalourethra Presented with Renal Anomalies
Authors: Khan Faisal , Sallam Hassan , Gad Moamen Taha , Khalil Omar , Alsayady Muath
Published: July 2024

Megalourethra is a rare congenital disorder of male penile tissue and urethra, characterized by nonobstructive dilatation of the urethra, mainly classified into scaphoid and fusiform types. It is commonly associated with multisystem involvement including hydronephrosis, hydroureter, posterior urethral valves, and vertebral, anal, and cardiac anomalies. The isolated entity is rarely found. Urethroplasty is a management modality to treat megalourethra with the treatment of other associated anomalies. In this article, we are presenting a case of megalourethra associated with right hydronephrosis, Grade 3–4 vesicoureteral reflux, small left kidney, and posterior urethral valve.
Validation of the Webb and Rivera Score in Predicting Complexity of Mohs Surgery Procedures: A Retrospective Study
Authors: Morr Claudia , Prechtel Taylor J. , Xue Gloria , Bell Maria C. , Slaven James E. , Que Syril Keena T.
Published: July 2024

Background:

Mohs micrographic surgeries (MMSs) vary in complexity and corresponding procedural duration. Preoperative triage of MMS cases enables physicians to estimate procedure duration and create an efficient schedule. The Webb and Rivera (WAR) score is a quantitative formula developed to predict complexity in Mohs cases based on tumor diameter, history of recurrence, location, and aggressiveness. Patients are given a score between 0 and 5 based on this information, with increasing surgical complexity for higher scores.

Purpose:

We aim to assess the association between WAR score, the number of stages, and repair type used in MMS to determine its value for clinical practice.

Methods:

Data for WAR score calculation were collected and analyzed for patients with squamous cell carcinoma and/or basal cell carcinoma treated with MMS between 2019 and 2023. Analyses were performed to determine if there was significant heterogeneity across WAR score groups. The Mantel–Haenszel Chi-square tests were performed for ordered categorical variables (Mohs stage), and Chi-square tests were performed for nonordered categorical variables. The results were verified using Fisher’s exact test when more than 25% of cells had an expected count of <5. Analyses were performed using SAS v9.4 (SAS Institute, Cary, NC).

Results:

Of the 712 patients who underwent MMS, 153 (21%) had a WAR score of 0, 270 (38%) had a WAR score of 1, 189 (26%) had a WAR score of 2, 75 (10%) had a WAR score of 3, 23 (3.2%) had a WAR score of 4, and 2 (0.2%) had a WAR score of 5. The average number of surgical stages increased as the WAR score increased, and the percentage of repairs using a flap or graft similarly increased for higher scores. While 86.2% of patients with a WAR score of 0 were cleared with one stage, this decreased to 75.5% with a score of 1, 74.6% with a score of 2, 72% with a score of 3, and 52.1% with a score of 4. Only two cases had a score of 5, both of which required two stages. In addition, only 13.7% of tumors with a WAR score of 0 required closure with a flap or graft, in comparison with 24.2% with a score of 1, 33.9% with a score of 2, 47.9% with a score of 3, and 47.7% with a score of 4.

Conclusion:

This study demonstrates that the WAR score is an effective predictive tool for identifying cases that may require multiple stages and more complex reconstructive techniques. Given that more complex cases will require increased operative time, a scheduling template that accounts for the level of complexity can lead to a more effective schedule. The WAR score may provide a practical tool for Mohs surgeons and their staff to triage incoming cases and design a schedule that allows for a consistent workflow.
A Cross-sectional Study on Prevalence and Determinants of Insomnia and Depression among Geriatric Population in Rural Coimbatore
Authors: Geetha A. , Sugunadevi G. , Ram T Mithula , Jayaraj Naveen Prabhu , Raja Ramasamy , Kumar Nawin Jai Vignesh
Published: July 2024

Introduction:

Aging is a natural phenomenon. Due to improved health-care facilities, the population of the elderly is increasing rapidly all over the world. Along with chronic morbidities, depression and insomnia are most commonly seen in elderly people, which might affect their quality of life. This study is done to identify the prevalence of depression, insomnia, and the factors associated among the study participants.

Methodology:

This is a cross-sectional study done among 350 elderly participants in a rural area of Coimbatore district. A multistage sampling method was used to select the study participants. Using a semi-structured questionnaire, Geriatric Depression Scale, and Insomnia Severity Index, data were collected and analyzed using SPSS version 20.

Results:

Among the study participants, 38.3% of them had mild-to-moderate depression and 7.4% of them had severe depression. Diabetes, death of a family member, people living alone, elderly people having conflicts in the family, and debts have statistically a significant association with depression. Similarly, 23.4% have subthreshold insomnia, 12.9% with clinical insomnia, and 8.3% of the study participants with severe insomnia. Factors associated with insomnia were conflicts in the family, debts, musculoskeletal disorders, and respiratory problems. Furthermore, there was a statistically significant association between depression and insomnia.

Conclusion:

The prevalence of insomnia and depression is high among the elderly. The factors associated with insomnia and depression were found to be health-related problems, economic causes, and social causes.
Comparing plaque removal efficacy of biodegradable toothbrush and nonbiodegradable toothbrush in children of 8–10 years of age: A randomized clinical study
Authors: Kariya Pratik B. , Desai Arohi , Singh Sweta , Bansal Barkha , Shah Yash
Published: July 2024

Introduction:

In the 21st century, we are surrounded by plastic, disposal of which has a detrimental effect on the environment. Around 700 million plastic toothbrushes are sold which contributes to a large portion of plastic waste. To aid in the restoration of the environment, there is a need to replace plastic toothbrushes with recyclable toothbrushes. The purpose of the study was to evaluate and compare the plaque removal efficacy of biodegradable toothbrushes and nonbiodegradable toothbrushes in children 8–10 years of age.

Methodology:

Ninety children 8–10 years old from school were included in the study. Toothbrush types to groups A (nonbiodegradable toothbrush, Colgate® Palmolive India Ltd.), B (Biodegradable toothbrush, Bamboo India), and C (Biodegradable toothbrush, Palette™ India) were randomly allocated and plaque score was evaluated using plaque disclosing agent and Turesky Modification of Quigley Hein Index at day 1, 7, and 14. The data were analyzed using unpaired “t” and analysis of variance to find the significance of study parameters between the groups and paired t-test was used to find the significance of study parameters within the group (pre- and postbrushing).

Results:

The comparison of plaque scores pre- and postbrushing in all groups manifested reduction from day 1 to 14. However, Group B showed a significant reduction of plaque on day 14 with a difference of 0.50 which is statistically significant with a P < 0.001.

Conclusion:

According to the results, it can be concluded that a biodegradable toothbrush has adequate plaque removal efficacy. Therefore, the use of biodegradable toothbrushes can be recommended which will reduce nonbiodegradable waste.
Minimally invasive tools are necessary for the modern practice of liver surgery
Authors: Yu Young-Dong , Halazun Karim J. , Chandwani Rohit , Samstein Benjamin
Published: July 2024

Introduction:

Minimally invasive liver resection (MILR) is performed for other gastrointestinal applications. At our centre, all liver resections are systematically performed using a minimally invasive approach. This study aimed to describe our experience in minimising open surgery and emphasised the importance of minimally invasive surgery.

Patients and Methods:

We retrospectively reviewed 260 patients who underwent liver surgery and compared the surgical outcomes between the open and MILR groups.

Results:

A total of 154 patients (68%) underwent MILR. The proportion of patients who underwent prior abdominal surgery and resection was higher in the open surgery group. However, the proportion of patients with liver cirrhosis was similar between the two groups. The MILR group was superior in terms of operative time, blood loss, Pringle manoeuvre rate and mean hospital stay. In addition, major complication and bile leak rates were lower in the MILR group. No significant differences in the tumour size, number of lesions or underlying liver pathology were observed between the two groups.

Conclusion:

Acceptable outcomes can be achieved even when the minimally invasive approach is considered the primary option for all patients who require liver resection. Minimally invasive tools are necessary for the modern practice of liver surgery; therefore, laparoscopic or robotic surgery should be included in the armamentarium of liver surgeons.
Identification of Circular Patterns in Capsule Endoscopy Bubble Frames
Authors: Mir Hossein , Sadeghi Vahid , Vard Alireza , Dehnavi Alireza Mehri
Published: July 2024

Background:

A significant number of frames captured by the wireless capsule endoscopy are involved with varying amounts of bubbles. Whereas different studies have considered bubbles as nonuseful agents due to the fact that they reduce the visualization quality of the small intestine mucosa, this research aims to develop a practical way of assessing the rheological capability of the circular bubbles as a suggestion for future clinical diagnostic purposes.

Methods:

From the Kvasir-capsule endoscopy dataset, frames with varying levels of bubble engagements were chosen in two categories based on bubble size. Border reflections are present on the edges of round-shaped bubbles in their boundaries, and in the frequency domain, high-frequency bands correspond to these edges in the spatial domain. The first step is about high-pass filtering of border reflections using wavelet transform (WT) and Differential of Gaussian, and the second step is related to applying the Fast Circlet Transform (FCT) and the Hough transform as circle detection tools on extracted borders and evaluating the distribution and abundance of all bubbles with the variety of radii.

Results:

Border’s extraction using WT as a preprocessing approach makes it easier for circle detection tool for better concentration on high-frequency circular patterns. Consequently, applying FCT with predefined parameters can specify the variety and range of radius and the abundance for all bubbles in an image. The overall discrimination factor (ODF) of 15.01, and 7.1 showing distinct bubble distributions in the gastrointestinal (GI) tract. The discrimination in ODF from datasets 1–2 suggests a relationship between the rheological properties of bubbles and their coverage area plus their abundance, highlighting the WT and FCT performance in determining bubbles’ distributions for diagnostic objectives.

Conclusion:

The implementation of an object-oriented attitude in gastrointestinal analysis makes it intelligible for gastroenterologists to approximate the constituent features of intra-intestinal fluids. this can’t be evaluated until the bubbles are considered as non-useful agents. The obtained results from the datasets proved that the difference between the calculated ODF can be used as an indicator for the quality estimation of intraintestinal fluids’ rheological features like viscosity, which helps gastroenterologists evaluate the quality of patient digestion.
Effectiveness of Hands-On Training Regarding Basic Life Support (BLS) on Knowledge Among Saveetha College of Arts and Science Final Year Students
Authors: Dayana BAA , Shek Abdullah M , Priyadarsini A , Cecyli C , Jagadeeswari J
Published: July 2024

ABSTRACT

Background:

Cardiac disorders are major global death causes, necessitating emergency measures in sudden cardiac arrests. Successful cardiopulmonary resuscitation, performed by medical team members, significantly reduces death rates from cardiac arrest, a growing concern across all age groups.

Aim:

The study evaluates the impact of hands-on basic life support (BLS) training program on final-year students’ knowledge of BLS.

Materials and Methods:

A pre- and post-test study was conducted among 60 students at Saveetha College of Liberal Arts and Science. A convenient sampling technique was used to select the samples. The demographic variables were collected by using multiple-choice questionnaires.

Result:

Results showed an effective level of knowledge and skill in BLS, indicating the need for further research.

Conclusion:

The study concludes that the level of knowledge and skill among final-year students of Saveetha College of Arts and Science was found to be effective in gaining knowledge regarding BLS in the post-test.
Morbidity pattern of tea garden residents of Darjeeling, India
Authors: Sarkar Rivam , Dasgupta Pallabi , Bhattacherjee Sharmistha
Published: July 2024

Tea industry is an important agroindustry of the northern part of West Bengal. Poor socioeconomic conditions, illiteracy, culture and food habit, overcrowding, make the population vulnerable to various communicable and noncommunicable diseases. This study was done to identify the pattern of communicable and noncommunicable diseases among the outpatient attendees of a tea-estate in Darjeeling, West Bengal, India. The cross-sectional record-based study was conducted among the beneficiaries of the tea-garden clinic. Among them, proportion having non-communicable diseases (65.2%) were higher than communicable disease (34.8%). Most of the communicable (61.9%) and noncommunicable (87.9%) diseases were among 20–60 years age group. Among them, majority of the communicable disease were respiratory (51.9%) and mainly upper respiratory tract infection (100%). In this age group, majority of the cardiovascular problem were hypertension (96%) and majority of the musculoskeletal diseases were joint pain (79%). It is necessary to have a knowledge of the recent trends of diseases in the area as reliable information on health problems of a population is an essential prerequisite for formulating health-care system to address health needs.
Knowledge and awareness regarding responsible antibiotic use among the general population of Shimoga district of Karnataka: A cross-sectional study
Authors: Wilson Sijin , Koppad Raghavendraswamy , Nagendra Kanchana , Kumari Sakshi , Liana C. , Joseph Ceethal Anna
Published: July 2024

Background:

Antibiotics are drugs used to treat bacterial infections. A major problem with the irrational use of antibiotics is the emergence of drug resistance. Antimicrobial resistance is a current problem worldwide, particularly in developing countries.

Objectives:

The objectives of the study were to evaluate the knowledge and awareness level of the general public of Shimoga district of Karnataka, regarding responsible antibiotic use and to correlate the findings with the sociodemographic details.

Methodology:

A community-based cross-sectional study was carried out in the Shimoga district of Karnataka. Data were collected from 800 adults by door-step interview using a questionnaire after obtaining consent. Data were entered in Microsoft Excel and were analyzed using Epi Info software.

Results:

Hardly 8% of the respondents could recall the name of the antibiotic and most were oblivious about the commonly used classes of drugs. Almost 60% believed that antibiotic therapy could be stopped as and when the symptoms were relieved or they felt alright. We tested the respondents’ knowledge of antibiotics and found that it was not favorable.

Conclusions:

We observed a significant gap in respondents’ knowledge and awareness of the responsible use of antibiotics. There is an urgent need for enlightening people on the dangers of the irrational use of antibiotics and training them on responsible ways of using antibiotics.
Monoclonal antibody usage pattern in a tertiary care center: A retrospective study
Authors: Sridhar Shruthi , Kumar Shivakumar Ajay , Teggihal Viraja , Bengalorkar Girish M. , Niveditha G.
Published: July 2024

Background:

Monoclonal antibodies (mAbs) are agents that are clones of homogenous parent B cells used in managing and diagnosing multiple conditions. They are used for individualized therapy for patients due to their high specificity for an antigen/epitope. Much needs to be understood about their utilization patterns in a developing country like India, where accessibility and cost play a major role in patient care.

Objectives:

The objectives of this study were to evaluate the drug prescribing patterns and indications for use of mAbs and compare their availability, with the essential drug list of the World Health Organization (WHO) and the National list of essential medicines in India (NLEM).

Materials and Methods:

This is a retrospective cross-sectional study conducted from July to December 2021. Data were collected from 237 patients who have visited the tertiary care center or been admitted and have received mAbs. Demographic data, department of admission, diagnosis on admission, and mAbs used during treatment were recorded and analyzed.

Results:

Out of the 237 patients, who were eligible for this study, 61.6% of them were males and 38.4% were females. The department of ophthalmology used mAbs most commonly (65.8%). Ranibizumab was the most used mAb in this department and overall.

Conclusion:

Out of the mAbs being used in the tertiary care center, only rituximab was part of the NLEM (India) essential drug list, and six more drugs were present in the WHO essential drug list. The advent of biosimilars is expected to bring costs down significantly for the patient and have better treatment outcomes.
Efficacy of estimations of Hartmann–Shack sensors in small pupil sizes
Authors: Bartol-Puyal Francisco de Asís , Giménez Galadriel , Méndez-Martínez Silvia , Larrosa José M. , Polo Vicente , Pablo Luis
Published: July 2024

PURPOSE:

The purpose of this study was to evaluate the in vivo efficacy of the estimations of wavefront analyzers using Hartmann–Shack technology to measure optical aberrations when the pupil size is smaller than the evaluated pupil area.

METHODS:

Patients implanted with the monofocal ZCB00 intraocular lens (Johnson and Johnson) were examined with the KR-1W Wavefront Analyzer (Topcon) without pharmacological mydriasis and with it afterward. Optical aberrations were analyzed considering a 4-mm pupil and a 6-mm pupil for both examinations.

RESULTS:

Sixty-six eyes of 33 patients with a mean axial length of 23.35 ± 0.91 mm were assessed. The mean pupil diameter at the baseline examination was 5.05 ± 0.88 mm and under pharmacological mydriasis, it was 6.29 ± 0.84 mm. Outcomes were similar with and without dilation in the 4-mm comparison. However, there was a great disparity in the 6-mm comparison. Most of the values obtained under mydriasis were statistically lower than at baseline (P < 0.05).

CONCLUSION:

The iris interferes with measurements of wavefront aberrations, and therefore, real pupil size should always be checked before evaluating optical aberrations with Hartman–Shack sensors. When pupil size is smaller than the analyzed diameter, ocular, and internal, and sometimes, corneal aberrations are estimated far more positive than real values.
Minimally invasive versus open pyeloplasty in pediatric population: Comparative retrospective study in tertiary centre
Authors: Alqarni Naif Hajar , Alyami Fahad Ali , Alshayie Mohammed Abdullah , Abduldaem Alhasan Mohamed , Sultan Mohammed , Almaiman Sultan Sulaiman , Alsufyani Hazim Mohammed , Abunohaiah Ibrahim Sami
Published: July 2024

Background:

Ureteropelvic junction obstruction (UPJO) is the most common cause of antenatal hydronephrosis. The incidence is around 1: 750–1500 live births. The standard treatment for (UPJO) is open pyeloplasty (OP) with a high success rate of 90%–95%. In the last 20 years, minimal invasive pyeloplasty (MIP) became an excellent alternative technique to OP which was historically the standard of care.

Materials and Methods:

The study participants were male and female patients aged 14 years old or less who had undergone open/minimally invasive pyeloplasty during 2015–2020 and who had at least 1-year follow-up after surgery. The data were collected retrospectively from patients’ charts. The patients were categorized into two cohort groups: OP and on the other arm minimally invasive pyeloplasty (robotic/laparoscopic) comparing the outcomes as a 1ry endpoint. 2ry endpoints were hospital stay, duration of surgery, and anteroposterior diameter of renal ultrasound.

Results:

A total of 133 patients were included in the study. Eighty-four underwent MIP while 49 patients underwent OP. 1ry endpoint was the success rate in both groups. The success rate was 94% (n: 79) and 98% (n: 48) in patients who underwent MIP and OP, respectively. P <0.05 is considered significant.

Conclusion:

Open and minimally invasive pyeloplasty are comparable in terms of success rate. However, OP was associated with shorter hospital stays and shorter operative times.
The effect of use of alpha-blockers in posterior urethral valve pediatric patients postvalve ablation in the absence of further outlet obstruction
Authors: Aboulela Waseem Nabil , Eladawy Mahmoud Shoukry , Latif Ahmed Abdel
Published: July 2024

Objectives:

The objectives of this study were to detect whether the use of alpha-blockers in posterior urethral valve (PUV) pediatric patients after valve ablation will improve the persistent obstructive symptoms despite the absence of obstruction and if there are associated side effects of its use.

Patients and

Methods: A prospective, single-blinded randomized study was conducted at the urology department of two hospitals on 50 male children between September 2019 and June 2021 with PUV. All children were treated by endoscopic ablation of PUV using the cold knife and were followed clinically for voiding symptoms and with ultrasonography and laboratory tests. All patients underwent second-look cystoscopy 1 month after primary valve ablation to see residual valves as a routine procedure confirming no remnant of the valve and still complaining of obstructive symptoms. They were divided into two equal groups 25 patients each. Group A was given alpha-blockers and Group B placebo for 1 month.

Results:

Marked improvement of obstructive symptoms in Group A reaching about 90% (21 patients), whereas no mentioned improvement in Group B was noticed with no side effects of both medication the alpha-blocker and the placebo during its use.

Conclusion:

The use of alpha-blockers improves the obstructive symptoms in pediatric patients with PUV after valve ablation and in the absence of any further urethral obstruction with no side effects noticed during the period of its use.
Exploring the incidence and characteristics of urolithiasis in the central region of Saudi Arabia: Insights from a prominent medical center
Authors: Alathel Abdulaziz , Alfraidi Omar , Alsayyari Abdulrahman Saad A. , Aljaafri Bader , Alsalamah Faris , Almeneif Hesham , Alsaif Abdurhman
Published: July 2024

Introduction:

Urolithiasis is a common and recurrent condition with a rising global incidence. Stones typically develop in the upper urinary tract, primarily the kidneys. Various factors such as age, gender, diet, fluid intake, climate, occupation, genetics, and metabolic diseases influence stone formation. Stones can vary in size and location, causing obstruction, urine stasis, and complications such as infection. The prevalence of urolithiasis in Saudi Arabia has significantly increased in recent decades, and the study aims to determine the current prevalence and composition trends of urolithiasis, guide treatment and prevention strategies, as well as understand predictors of occurrence and recurrence.

Materials and Methods:

It is a retrospective cohort study where the data was collected in the time frame of 2015–2021. The study was conducted in the Department of Surgery and the Division of Urology at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia.

Results:

The study reveals significant trends in the sociodemographic profile and clinical aspects of urolithiasis patients. With a higher incidence among males (68.5%). Stone compositions predominantly consist of calcium oxalate (67.8%) and uric acid (19.7%), while site distribution shows the left kidney as the most common location (36.5%). Notably, hypertensive patients exhibit a significant association with stone site (P = 0.014). Encouragingly, the majority of patients do not experience reoccurrence (91.6%), and the study demonstrates an increasing recurrence rate with subsequent visits. The relatively shorter hospital stays (55.9% with 1-day stays) indicate efficient management, and this knowledge can aid in optimizing patient care.

Conclusion:

This study sheds light on the multifaceted nature of urolithiasis by examining various facets. Low recurrence rate of kidney stones offers positive prospects for effective initial management. The shorter hospital stays, suggest advancements in medical practices, enhancing patient convenience and healthcare resource optimization. Investigating the underlying causes behind the observed stone compositions yield insights into potential preventive strategies. Furthermore, extended studies examining the impact of lifestyle modifications and medical interventions on stone recurrence could contribute to refined treatment protocols. These findings can guide healthcare professionals in optimizing patient care, preventive strategies, and future research endeavors.
Role of lingual mucosa as a graft material in the surgical treatment of Peyronie’s disease
Authors: Shukla Pushpendra Kumar , Singh Aditya Kumar , Trivedi Sameer , Dwivedi U. S. , Ramole Yashpal , Khan Faiz Ahmed , Pandey Manish
Published: July 2024

Background:

Peyronie’s disease (PD) is a localized fibrosis of tunica albuginea, which causes the anatomical and functional changes to the penis. Corporoplasty with grafting is indicated in severe (>60°) and complex curvature. Buccal mucosa is the most favored autologous graft material nowadays. The ventrolateral aspect of lingual mucosa has similar histological features to the rest of the oral cavity.

Methods:

This study aimed to test the efficacy, safety, durability, and reproducibility of corporoplasty with lingual mucosal graft (LMG) in the surgical treatment of PD in terms of surgical outcome, sexual function, and donor site complications. This prospective study included 19 patients of PD with severe and complex curvature, who underwent corporoplasty with LMG. Surgical and functional outcomes were assessed at follow-up planned at 2 weeks, 3 months, 6 months, 1 year, and 2 years.

Results:

The mean operative time was 126.31 ± 21.45 min. Additional Nesbit’s plication to correct the residual deformity was required in 26% (5 / 19) of patients. Straightening of the penis (curvature <10°) was achieved in 89% (17 / 19) of patients. Increase in the penile length (>1 cm) postoperatively was achieved in 63% (12 / 19) of patients and a shortening of penis occurred in 5% (1 / 19) of patients. Newer onset erectile dysfunction developed in 11% (2 / 19) of patients, and patient and partner satisfaction rates were 89% (17 / 19) and 84% (16 / 19), respectively, in a mean follow-up of 20.66 ± 5.37 months. Donor site complications were minimal and no patient had any salivary changes or speech disturbances.

Conclusion:

LMG provided excellent short-term results in terms of deformity correction, improved sexual function, and minimal donor site morbidity. The method is simple and reproducible, and multicenter studies with larger number of cases with longer follow-up are required to confirm these favorable results.
Sperm extraction in nonmosaic Klinefelter syndrome patients: A case series and literature review of sperm extraction in Klinefelter syndrome patients
Authors: Alrabeeah Khalid , Alkhayal Abdullah , Aljumaiah Sahar Mohammed , Alghafees Mohammad , Alqarni Almohannad K. , Hakami Basel Othman
Published: July 2024

Objectives:

Klinefelter syndrome (KF) is a group of chromosomal disorders with at least one extra X chromosome in male individuals that leads to infertility and diminished hair growth in affected males. In this study, we present a case series of 16 nonmosaic KF and an extensive literature review.

Patients and Methods:

This is a retrospective study including 16 nonmosaic Klinefelter Syndrome patients that underwent micro-testicular sperm extraction (m-TESE) at our center between January 2016 and December 2022. Frequencies and percentages were used to present categorical variables, whereas continuous variables were presented as the median and interquartile range (IQR). The sperm retrieval rate (SRR) was assessed using a one-sample proportions test with continuity correction. Fisher’s exact test was to assess the differences between patients with negative and positive retrieval in terms of the categorical variables. A Wilcoxon rank-sum test was applied to explore the between-group differences in the numerical variables. A literature search was performed for additional publications of discussing m-TESE among KF patients.

Results:

The median (IQR) age of patients was 40.0 years (34.5–47.0). All of the patients had nonobstructive azoospermia, and the majority of them (93.8%) had primary infertility. The most common histopathological findings were atrophic tubules (57.1%), followed by Sertoli cell-only (28.6%). Sperm retrieval was positive for two patients with a rate of 12.5% (95% confidence interval 2.2 to 39.6). Patients with positive sperm retrieval were significantly younger than their peers with negative retrieval (median = 28.0, IQR = 27.5 to 28.5 vs. median = 41.5, IQR = 35.8 to 47.0, P = 0.031). The successful conception rate was 100% (n = 2) using intracytoplasmic sperm injection with a birth rate of 100% (n = 2).

Conclusion:

Our observed SRR among nonmosaic KF patients was marginally lower than the reported literature. Younger-age patients were significantly more likely to benefit from the procedure.
The impact of age, sex, comorbidities, and use of antithrombotics on the clinical course severity among patients surgically treated for urinary bladder tamponade
Authors: Jakus Dora , Šitum Marijan , Čepin Petra , Vrhovac Ivana , Borovac Josip Anđelo
Published: July 2024

Objectives:

To examine the relationship between clinical patient characteristics and the severity of the disease course in patients hospitalized due to urinary bladder tamponade. The severity was assessed based on hemoglobin (Hgb) levels upon admission, the requirement for red blood cell transfusion (RBCT), and length of hospital stay.

Materials and Methods:

A retrospective analysis was conducted at a single center, involving 75 patients who were hospitalized due to urinary bladder tamponade.

Results:

Bladder cancer (33.3%) and postoperative bleeding (28%) were the most common causes of bladder tamponade. Patient age exhibited a negative correlation with Hgb levels upon admission (r = −0.539, P < 0.001) and a positive correlation with the quantity of administered RBCT units (r = 0.425, P < 0.001) and the length of hospitalization (r = 0.541, P < 0.001). The number of comorbidities exhibited a negative correlation with Hgb levels upon admission (r = −0.555, P < 0.001) and a positive correlation with the quantity of administered RBCT units (r = 0.522, P < 0.001) and the length of hospitalization (r = 0.543, P < 0.001). Patients taking antithrombotic therapy (AT) had lower mean Hgb levels on admission (87.8 ± 13.5 g/L vs. 107.6 ± 18.7 g/L, P < 0.001), a higher mean number of administered RBCT units (2.8 ± 2.1 vs. 1.1 ± 1.3, P < 0.001) and longer hospitalizations (4.6 ± 1.6 days vs. 3.1 ± 1.1 days, P < 0.001) compared to those not taking AT.

Conclusion:

Older patients with multiple comorbidities, particularly those taking AT, should be expected to have a more severe clinical course of bladder tamponade. Therefore, special clinical attention is necessary for this vulnerable patient group.
Screening of overactive bladder syndrome and its relation with insomnia: A public health experience
Authors: Bakry Salah , Nassir Anmar , Bakry Suhayb , Saati Bassam Abdullah , Alotaibi Mohammed Bandar , Alomairi Mohanned Mohammed
Published: July 2024

Background:

Overactive bladder (OAB) syndromes are a vital global issue linked to sleep disturbances and insomnia. This survey explores the relationship between these health burden issues and their risk factors.

Methodology:

A survey-based study was conducted among Makkah city citizens’ in April 2023. A standardized tool of OAB symptom score and Insomnia Severity Index was used to screen participants. The collected data were statistically analyzed using SPSS.

Results:

Overall, 529 participants were enrolled in this survey with mean = 37.3 and standard deviation = 13.7. Most participants had mild OAB 74.67%, while insomnia represents no clinically significant subtype among the majority 55.39%. About 25.33% of participants had clinical OAB (moderate and severe), while approximately 44.61% had insomnia. Similarly, participants with the mild subtype of OAB show a significant correlation with no clinically significant subtype of insomnia (P ˃ 0.001). Furthermore, participants with moderate OAB were statistically associated with subthreshold insomnia (P ˃ 0.001).

Conclusion:

Medical attention and public awareness are mandatory for the early detection of OAB and insomnia.
Optimized Energy Efficient- Hierarchical Clustering Based Routing (OEE-HCR) For Wireless Sensor Network (WSN)
Authors: Sophia Reena G , Nithya S
Published: July 2024

The study into Wireless Sensor Network (WSN) has grown more crucial as a result of the many Internet of Things (IoT) applications. Energy – Harvesting (EH) technology can extend the lifespan of WSN; however, because the nodes would be difficult to get to during energy harvesting, an energy-efficient routing protocol should be developed. The use of clustering in this study balances energy consumption across all Sensor Node (SN) and reduces traffic and overhead throughout the data transmission phases of WSN. Cluster Head (CH) selection step of the Optimized Energy Efficient-Hierarchical Clustering Based Routing (OEE-HCR) technique involves sending data to the closest CH. In order to analyse and transmit each cluster data, CH will need to use more energy, which will hasten and asymmetrically deplete the network. Whale Optimization Algorithm (WOA) algorithm is introduced for the best number of clusters formation with dynamically selecting the CH. Experimentation analysis, results are measured using First Node Dead (FND), the Half Node Dead (HND), Last Node Dead (LND), and Maximum Lifetime Coverage (MLC) at the time of number of data transmission rounds performed in routing algorithms.
Super rewriting theory and nondegeneracy of odd categorified $\mathfrak{sl}_{2}$
Authors: Dupont Benjamin , Ebert Mark , Lauda Aaron D.
Published: July 2024

We develop the rewriting theory for monoidal supercategories and

2

-supercategories. This extends the theory of higher-dimensional rewriting established for (linear) 2-categories to the super setting, providing a suite of tools for constructing bases and normal forms for

2

-supercategories given by generators and relations. We then employ this newly developed theory to prove the non-degeneracy conjecture for the odd categorification of quantum

\mathfrak{sl}(2)

from A. Ellis and A. Lauda [Quantum Topol. 7 (2016), 329–433] and J. Brundan and A. Ellis [Proc. Lond. Math. Soc. (3) 115 (2017), 925–973] As a corollary, this gives a classification of dg-structures on the odd

2

-category conjectured by A. Lauda and I. Egilmez [Quantum Topol. 11 (2020), 227–294].
COVID-19 control protocol for rhinologic surgery
Authors: Takagi R , Oka A , Kitamura H , Kamitomai M , Akamatsu M , Kanai K , Watanabe Y , Imanishi Y , Noguchi Y , Okano M
Published: July 2024

In January 2020, 14 medical staff members engaged in endona- sal endoscopic pituitary surgery at a hospital in Wuhan, China, were infected with a novel infection, coronavirus disease 2019 (COVID-19) (1). Since the nasal mucosa is a potential source of COVID-19 infection (2), close attention has been paid to infection control in rhinologic surgery during the COVID-19 pandemic (3). There are also many reports from other countries on COVID-19 infection among otolaryngologists, and these reports suggest that the risk of COVID-19 transmission is particularly high in rhinologic surgery (4,5). On the other hand, Sanmark et al. showed that the observed aerosol exposure during rhinologic surgery is lower or similar to exposures during coughing (6).