bluuebunny/crossref_metadata_2025 huggingface dataset:
A description of thyroid cancer histology subtypes over 10-year period from 2011-2020 at teaching hospital Batticaloa
Authors: Hendavitharana Y.V. , Bandara K.H.N.S.P. , Sanooz A.R.M. , Mayurathan P.
Published: September 2024

Introduction: Thyroid cancer is the most common malignant disease in endocrine system and is rapidly increasing in incidence worldwide. Currently it is the 2nd most common cancer among Sri Lankan women. Differentiated thyroid carcinoma (DTC) includes papillary and follicular types and they are the commonest thyroid cancers. Medullary and anaplastic types of thyroid cancers are other few of the histological types.
Objectives: To describe the prevalence of different thyroid cancer histology subtypes according to the gender and age categories reported at Teaching Hospital Batticaloa (THB)
Methodology: This retrospective descriptive study was carried out based on cancer database at histopathological unit THB. Study included 235 thyroid histology reports from 1st of January 2011 to 31st of December 2020. Permission for collecting data was obtained from the Director, THB. Ethical clearance for the study was obtained from Ethical Clearance Committee, Faculty of Health-Care Sciences, Eastern University, Sri Lanka.
Results: This study had 83.8% (N=197) of females and 16.2% (N=38) of males. In both genders, the commonest histological type was papillary (n = 155, 66%) followed by follicular (n = 60, 25.5%), medullary (n = 15, 6.4%), anaplastic (n = 5, 2.1%) within the 10-year period. Each year papillary cancer was the most prevalent type except 2013, where the follicular type was commonest. Follicular type was the second commonest type during the 10-year period except 2013, 2014 and 2020. In 2013 the papillary type was the second commonest and in 2014 and 2020, medullary cancer was noticed in second place. Anaplastic type was the least reported during each year and wasn’t noticed during 2012, 2013, 2015, 2016, 2019 and 2020. Males had no reported cases of anaplastic cancer during the 10-year period. Majority of cancer cases were prevalent between 15-59 years old and the papillary carcinoma was the predominant one in this age group. Anaplastic type was more common above 60 years old.
Conclusion: The most prevalent types of thyroid carcinoma reported at THB belongs to DTC. But there were considerable number of medullary types with certain peaks during 2014 and 2020 and a few cases of anaplastic type during the 10-year period. There was no fixed trend identified in the prevalence of different histological types during the 10-year period.
Clinical presentation and aetiology of pleural effusion among patients with chronic kidney disease referred to the Respiratory Unit of National Hospital, Sri Lanka
Authors: Yamini V.
Published: September 2024

Identification of pleural effusion patterns among chronic kidney disease patients is helpful in the early detection and management and in implementing preventive measures to reduce the occurrence of pleural effusion in CKD patients. The objective of this study is to describe the clinical presentation and aetiology of pleural effusion among chronic kidney disease patients referred to the Respiratory Unit of National Hospital Sri Lanka (NHSL).
A hospital-based prospective study was carried out among patients referred to the Respiratory Unit of NHSL from November 2020 to May 2021. Data were obtained by history taking, clinical examination and from investigation reports.
A total of 48 patients were recruited. The mean age was 55.4 years. The male-to-female ratio was 1.5:1.0. About 95% of patients had diabetes or hypertension as a comorbidity. The majority of effusions were unilateral (83%), and moderate in size (58%). About 33.3% of cases were due to transudative effusion and caused by fluid overload, heart failure or hypoalbuminemia. The remaining 66.7% of effusions were exudative. TB pleural effusion, parapneumonic effusion, lung cancer and non-specific pleuritis were the causes of exudative effusion.
Many pleural effusions were preventable. Improving access to haemodialysis, infection preventive measures, personal hygiene and improving nutritional status could be beneficial in the prevention of pleural effusion.
A Rare Case of Synchronous Gastrointestinal Stromal Tumour, Liver Haemangioma and Sigmoid Colon Adenocarcinoma
Authors: Trishan S. Vivian , Nimalaranjan T.R.
Published: September 2024

Multiple primary tumours refer to the occurrence of more than one tumour in the same individual either at the same time (synchronous) or at different times (metachronous). The incidence of multiple primaries in a cancer population varies between 2.4% and 8%. This case report discusses the management of a 61-year-old woman who presented with upper abdominal pain and melaena and ultimately ended up being diagnosed with three different tumours of various histological origins, which are liver haemangioma, gastrointestinal stromal tumour of the stomach and moderately differentiated adenocarcinoma of the sigmoid colon. This case explains the importance of a systematic approach to diagnosis and management and highlights the limitations of imaging studies in diagnosing synchronous primary malignancies. It emphasises the significance of multidisciplinary collaboration in optimising patient outcomes.
Family Medicine and Primary Care: Challenges in Healthcare System
Authors: Arulanandem K.
Published: September 2024

No abstract available.
Parent-adolescent sexual communication in Asia: point of view and implications for future interventions
Authors: Mataraarachchi Dilini , Pathirana T.E.A. , Vithana Chiranthika
Published: September 2024

No abstract available
COVID-19 vaccine uptake among nursing officers: a cross-sectional study in a tertiary care hospital in Sri Lanka 
Authors: Karunaratne Liyamini , Seneviwickrama Maheeka
Published: September 2024

Introduction: Vaccination against COVID-19 was considered an i mportant public health intervention to control the pandemic. However, the vaccine uptake was not satisfactory among Asian nurses and less explored in Sri Lankan setting. Objectives: To describe the compliance with the COVID-19 vacci ne among nurses in a tertiary care hospital in Sri Lanka with its associated factors Methods: This cross-sectional study was conducted in January 2022,  one year after the introduction of the COVID-19 vaccination to Sri Lanka. Stratified sampling method was used to select 415 nurses from District General Hospital Matara. Data collected using a pre-tested, self-administered questionnaire were summarized with descriptive statistics. Uptake of two primary doses and one booster dose was considered full compliance. The associations were evaluated with the Chi-squared test at p<0.05 significance level and adjusted f or confounders using multiple logistic regression. Results: With a 91.1% response rate (n=378), full compliance with  the COVID-19 vaccine was noted among 51.8% (n=196). There had been an active demand for the first dose among  84.7% which declined to 70.9% and 26.7% by the second and booster doses, respectively. Only 107 (28.3%) were willi ng to accept another dose if recommended in the future. The most influential reason for vaccine uptake as reported  by a majority was to prevent complications of COVID-19 disease. The most reported reason for reluctance was the  vaccine’s inability to protect against new strains of the virus. Age, nursing qualifications, nursing grade and knowle dge on COVID-19 vaccine showed a significant association with vaccine uptake in bivariate analysis. However, onl y knowledge retained significant with vaccine uptake (adjusted odds ratio (aOR)=1.9; 95% CI=1.2, 2.9; p=0.003)  after adjusted for confounding effects using multiple logistic regression. Conclusions & Recommendations: There exists a gap in com pliance with COVID-19 vaccine among study participants. Targeted interventions should aim to empower and impr ove vaccine related knowledge among nurses in future vaccination programs.
Burden of oral health issues and its association with the participation in ‘Health care for Newly Wedded Programme’ among reproductive aged pre-conceptive married women before their first pregnancy in Kalutara district, Sri Lanka
Authors: Gayathri Hewage Dona Vindya , Ratnayake Nilantha
Published: September 2024

Introduction: Oral diseases are major public health problem among reproductive aged pre-conceptive married women. ‘Healthcare for Newly Wedded’ programme (HNWP) address the oral health issues among them.Objective: To assess the effect of HNWP on the oral health status among reproductive aged pre-conceptive married women before their first pregnancy in Kalutara district.Methods: Community based descriptive cross-sectional study was conducted among 820 of married women before their first pregnancy in Kalutara district using an interviewer administered questionnaire and a clinical oral examination. Categorical data were presented as percentages and 95% confidence intervals (CI). Bivariate analysis was done for comparisons and multivariate analysis was done to adjust for confounders.Results: Preconceived married women carried a considerable burden of oral diseases (dental caries – 46.7%, calculus – 46.0%, gingival bleeding – 31.6%). There was a potential to reduce the presence of active dental caries by referring them to a dental clinic under the HNWP (OR = 0.443, P = 0.001).Conclusion and recommendations: Referral to a dental clinic at HNWP should be improved to improve the oral health status of this target group since the HNWP is effective in reduction of dental caries.
Public health through fostering collaboration and building resilience
Authors: Maduwage Shiromi
Published: September 2024

No abstract available
Biology and phenomenology of brain death
Authors: Anile Carmelo , Maira Giulio
Published: September 2024

Not available.
Brain death The resuscitator's behaviour
Authors: Proietti Rodolfo , Zanghi Filippo
Published: September 2024

It should be premised that the fundamental objective of the resuscitator is not to ascertain brain death but to prevent it. To this end, pharmacological and instrumental therapy measures aimed at restoring normal brain function must be taken in all patients with a severe lesion of the Central Nervous System, and thus an elevated risk of brain death.
Ethics Committees in Hospitals
Authors: Spagnolo Antonio
Published: September 2024

In the face of the increasing technicalisation of medicine, increasingly daring experimentation, especially in the initial and terminal phases of life (on embryos, on the terminally ill), and the dehumanisation of the hospital structure, there is a widespread need to bring the field of biomedical sciences back to a human scale by setting up committees that can somehow safeguard the fundamental purpose of medicine, which is to cure man and defend his dignity as a subject during the healing process itself.
Christian conscience in the face of atheism and indifference
Authors: Bausola A.
Published: September 2024

Not available.
Ethical aspects of intensive care in the very low birth weight infant
Authors: Zuppa Antonio Alberto
Published: September 2024

Not available.
Effectiveness of group work among the final radiography students of the National Diploma
Authors: Menwe Kealeboga P. , Hazell Lynne , Lawrence Heather A.
Published: September 2024

Background: Group work is employed in higher education institutions to foster communication, collaborative learning, leadership qualities and teamwork skills. The rationale behind group work as a learning strategy is to ensure that graduates are equipped with teamwork skills.Aim: The aim of this study was to establish whether the final-year radiography students of the National Diploma curriculum in three universities in South Africa were exposed to effective group work.Setting: The study was conducted in three universities in South Africa, all of which offer diagnostic radiography programmes.Methods: This study used a non-experimental descriptive design to collect data. A purposive sampling technique was used to select participants. This was an attempt to conduct a census on 167 students, out of which 124 students responded to the questionnaire, giving a response rate of 74.25%.Results: The findings show that the majority (n = 81; 66.9%) of students did not enjoy group work, as 101 (81.5%) of them preferred less group projects. The results further demonstrated that participants rated factors such as co-operation, leadership, choice, diversity and effectiveness of group work neutral on the Likert scale.Conclusion: The study results imply that factors that contribute towards the effectiveness of group work should be incorporated into group activities in order for student radiographers to be exposed to effective group work. The gaps identified in this study indicate the need for a follow-up study within the current 4-year bachelor’s degree in radiography.Contribution: Identification of a gap in radiography education, which group work needs to be facilitated effectively.
Contextual entrepreneurship and gender: The case of Nigeria in relation to developed countries
Authors: Gutiérrez-Broncano Santiago , Jiménez-Estévez Pedro , Opute John , Díaz-García María-Cristina , Giraldo-Giraldo Camilo
Published: September 2024

Purpose: There is a need to better understand the impact of different contexts depending on their economic and social development on women’s entrepreneurial experience, that is how belonging to certain cultures may affect women entrepreneurs’ experiences differently.Design/methodology/approach: Using interviews, this research explores the narratives of 35 women entrepreneurs in Nigeria (sub-Saharan Africa) in a context of scarcity and where the burden of care and support falls on women. It is important to understand how entrepreneurs feel and think about the barriers and catalysts they have encountered and their identity in specific contexts.Findings/results: In Nigeria, the discourse around women entrepreneurship revolves around personal characteristics that women should emphasise, such as self-confidence, self-efficacy and determination. Therefore, they build their identity in a communitarian and pluralistic way, which is not common in developed countries that are more individualistic.Practical implications: We cannot assume that a developed world perspective, however dominant, is well-equipped to explain entrepreneurship everywhere. In developing countries, women still must fight for their legitimacy as entrepreneurs, while in developed countries women show greater agency in trying to counteract the gendered construction of entrepreneurship.Originality/value: The article follows calls in the literature, specifically that dealing with women’s entrepreneurship, to contextualise the analysis, focus on developing countries and use a qualitative approach.
Investigation of neuroprotective effects of H2 by CiteSpace-based bibliometric analysis
Authors: Feng Yan , Wu Chuanjie , Song Baoying , Zhang Yang , Jiang Miaowen , Qi Zhengfei , Chen Le , Li Anzhi , Ye Hanming , Liu Biluo , Feng Yu , Ji Xunming , Ma Zhengfei , Li Ming
Published: September 2024

BACKGROUND AND AIMS:

Neuroprotection plays an important role in the treatment of brain disorders. In recent years, studies using rat models and clinical trials have demonstrated the positive effects of hydrogen treatment on neurological disorders and brain injuries. Hence, it is of great significance to shed light on this issue. In this article, CiteSpace is employed for visualization and bibliometric analysis of the research frontiers and evolving trends related to the neuroprotective effect of hydrogen.

METHODS:

All articles published from 2009 to 2023 that discussed the neuroprotective effects of hydrogen in cerebrovascular diseases were retrieved from the Web of Science. Using CiteSpace, a visualization analysis was conducted on aspects such as countries, institutions, authors, keywords, and Co cited references, which enables an intuitive observation of current research hotspots.

RESULTS:

After manual screening, a total of 106 articles were retrieved. Over time, The number of publications has increased annually. Regarding national contributions, the top three countries with the highest number of publications include China, the United States, and Japan. The Second Military Medical University is the institution that publishes the most articles and has significant influence in the field of hydrogen neuroprotection. Sun, Xuejun and Domoki, Ferenc were the most productive. The most common keywords include hydrogen, oxidative stress, inflammation, and apoptosis. Potential areas of focus for future research consist of early brain injury, hydrogen, ischemia-reperfusion injury and hypothermia treatment.

CONCLUSION:

The bibliometric study presented herein offers insights into the current status and trends of research on hydrogen in the field of cerebrovascular diseases. Future research trends suggest that hydrogen contributes significantly to the cerebrovascular domain through its anti-inflammatory, antioxidative, and anti-apoptotic mechanisms. This study can aid researchers in identifying hot topics and exploring new research directions.
Successful Long-term Treatment with Modified Dose Pemigatinib in FGFR2-BICC1 Intrahepatic Cholangiocarcinoma: A Case Report
Authors: Lai Kuan-Chang , Chen Ming-Huang
Published: September 2024

Patients with advanced intrahepatic cholangiocarcinoma (iCCA) have a poor prognosis. Recent advances in molecular profiling offer hope by enabling targeted treatment for those with specific mutations, potentially increasing survival rates. Pemigatinib targets fibroblast growth factor receptor 2 (FGFR2) fusions or rearrangements, providing a promising avenue for treatment. Here, we report the case of a 70-year-old woman diagnosed with advanced iCCA, characterized by FGFR2-Bicaudal family RNA binding protein 1 (BICC1) fusion, who received pemigatinib therapy. Despite adverse effects including mucositis and nail changes, she continued treatment following dose adjustments for over 18 months. This report highlights the importance of dose optimization in maintaining patients on therapy and preventing treatment discontinuation. Real-world patients are often more fragile than those in clinical trials, necessitating tailored dose adjustments. However, the literature on alternative dose modifications remains limited. This case represents the longest documented successful treatment of advanced iCCA with pemigatinib in Taiwan, emphasizing the potential efficacy of pemigatinib treatment in a real-world setting.
Spectrum of orbital fat necrosis in rhino-orbital-cerebral mucormycosis in post-COVID-19 patients
Authors: Agrawal Akanksha , Diwaker Preeti , Dixit Sonali , Rohatgi Jolly , Arora Vinod K
Published: September 2024

Purpose:

Rhino-orbital-cerebral mucormycosis (ROCM) is the most common presentation of mucormycosis. Sinonasal–orbital debridement with exenteration is a life-saving procedure in ROCM patients in view of severe involvement of sinuses and the eyeball. Following the second wave of coronavirus disease 2019 (COVID-19), there was a massive surge in mucormycosis cases in India in post-COVID-19 patients. Of over 300 cases of mucormycosis admitted in our hospital, many underwent exenteration and these specimens were evaluated histopathologically, where fat necrosis was found to be a prominent finding. The spectrum of fat necrosis in ROCM in orbital fat has not been described in literature. Hence, we sought to evaluate the significance and spectrum of orbital fat necrosis in ROCM.

Methods:

This 3-month retrospective study included 15 cases of ROCM which underwent exenteration. Clinical data, radiologic details, and histopathologic findings were tabulated. Sections were also subjected to Periodic acid Schiff (PAS) and Gomori’s methenamine silver (GMS) stains for confirming the fungus.

Results:

All 15 cases showed fat stranding on computed tomography (CT) scan. On histopathologic examination, various tissue reaction patterns observed included acute/chronic inflammatory infiltrate, suppurative granulomas with giant cells, coagulative and fat necrosis, broad aseptate fungal hyphae with or without angioinvasion, and neural invasion. Fungal hyphae were confirmed with PAS and GMS stains. The spectrum of fat necrosis observed in all the cases included 1) acute necrotizing fat necrosis, 2) ghost adipocytes with or without saponification, and 3) crystalline/gouty fat necrosis.

Conclusion:

Fat necrosis is a significant finding in ROCM, both on CT scan and histopathology. All three patterns of fat necrosis may be observed simultaneously in a case of ROCM.
Hypersecreting Jugulotympanicum Paraganglioma: A Rare Entity and Its Management
Authors: Malik Muhammad Fawwaz Meor Abdul , Abdullah Asma , Xiang Tan Choo , Ping Wong Yin , Budiman Maryam
Published: September 2024

Jugulotympanicum paraganglioma, a rare benign tumor originating from paraganglionic cells, typically afflicts females aged 50–60 years, with hypersecretion observed in only 2%–4% of cases. Before surgery, meticulous preoperative optimization is imperative, involving the administration of alpha- and beta-blockers to manage cardiovascular parameters. Surgical excision, preceded by angioembolization to reduce intraoperative bleeding risk, remains the preferred treatment modality. We present a case of a 33-year-old male with a catecholamine-secreting left jugulotympanicum paraganglioma, managed successfully with a collaborative effort from multiple disciplines. Intraoperative monitoring ensured hemodynamic stability despite transient hypotensive episodes, with the patient subsequently receiving radiotherapy and placed on surveillance protocols. This case underscores the importance of interdisciplinary collaboration and comprehensive management for optimal outcomes in treating hypersecreting jugulotympanicum paraganglioma.
A study to evaluate nomophobia and social anxiety disorder among students
Authors: Bodepudi Sarath , Benerji Therissa , Kaur Ravneet , Pallekona Roshini , Kodali Madhavi , Parvathaneni Krishna Mohan
Published: September 2024

Background:

The term “nomophobia,” an abbreviation for “no-mobile-phone phobia,” is characterized by the fear/discomfort caused by the inability to use a smartphone. While the use of technology may provide innumerable benefits for users, it can also reinforce behavioral dysfunctions such as social avoidance. This study was conducted to screen for nomophobia among undergraduate medical students and evaluate its relationship with social anxiety disorder.

Aims:

To evaluate the relationship between nomophobia and social anxiety disorder among undergraduate medical students.

Methods:

Five hundred participants above 18 years of age and using a smartphone with a score of ≥21 on the Nomophobia questionnaire (NMP-Q) were taken as subjects for the study. The NMP-Q and Liebowitz social anxiety scale were used to assess the levels of nomophobia and social anxiety, respectively.

Statistical Analysis Used:

Statistical analysis was done using SPSS version 25.

Results:

Among the participants, 56.4% had moderate levels of nomophobia, 37.2% had mild, and 6.4% had severe nomophobia. Of those found to have social anxiety, 57.4% had moderate levels of social anxiety, 26.4% had severe, and 6.6% had very severe social anxiety. The level of nomophobia was found to be significantly associated with the average time spent daily using a smartphone. A highly significant association has also been observed between the level of nomophobia and the severity of social anxiety.

Conclusion:

Our results highlight the need for future investigations focusing on the association between nomophobia and social anxiety. Delineating these relationships can inform effective screening and mitigation strategies for social anxiety in tech-heavy environments.
Reinforcing the importance of reflective practices among medical students: The CBME way
Authors: Annadurai Kalaivani
Published: September 2024

Reflective practice is a crucial component of medical education, fostering self-awareness and continuous improvement among medical students. Competency Based Medical Education emphasizes the development of specific competencies rather than traditional time-based training, ensuring that learners acquire the necessary skills and knowledge to provide high-quality patient care. Reflective practice, allows students to critically analyze their experiences, identify areas for improvement, and adapt their learning strategies accordingly. The incorporation of regular reflective practices in medical education helps students to develop a deeper understanding of their clinical experiences, promoting critical thinking, problem-solving skills, set personal learning goals, and monitor their progress. This process not only enhances their clinical skills but also contributes to their professional growth and emotional resilience, preparing them for the complexities of medical practice. To conclude, by integrating reflective practices into their education, medical students can cultivate a habit of self-reflection, leading to improved patient care and a more resilient healthcare workforce.
Post-inguinal herniotomy keloid in pediatric age groups – A case report with review of the literature
Authors: Narahari Janjala , Vepakomma Deepti
Published: September 2024

Abnormal wound healing causes keloid formation. Keloids are the most challenging conditions for the surgeons and dermatologists despite their high prevalence. Keloids are often symptomatic and can have a cosmetic nuisance as well as significant psychosocial burden for the patient. Although multiple treatment modalities exist, no single treatment has proven widely effective. In fact, recurrence following treatment is generally the normal. Combination therapy is likely the optimal strategy. In this case report, we highlight the clinical features of post-herniotomy keloid in children, pathophysiology, and management of keloids.
Long-term morbidity post level III lymph nodal dissection in cancer breast patient: Institutional experience
Authors: Dwivedi Surjeet K. , Dinker Yateendra , Kumar Surendra , Dwivedi Sabita , Anshu Alok
Published: September 2024

Introduction:

Breast cancer is one of the commonest cancers worldwide in females with a variable rate of incidences across countries and regions. The extent of axillary dissection has now been restricted to lower levels, i.e., Level I and II; however, there are certain instances where level III lymph nodal (LN) dissection is performed. NCCN 1.2022 for breast cancer management suggests level III LN dissection if gross disease is detected during axillary dissection. Axillary lymph node dissection (ALND) itself could lead to various complications which could be classified as early or late. Early sequelae include post-operative pain, neuralgia, hematoma, or seroma formation while late sequelae include upper limb lymphedema, restriction of arm movements, fibrosis, and contractures of the shoulder joint and shoulder girdle muscles, reduced muscle strength in the limb and shoulder or winging of the scapula.

Methods:

A prospective observational study was performed at a single tertiary care center where 70 consecutive breast carcinoma patients who underwent level III ALND were followed up for two years for their disabilities.

Results:

In our patient subset, most of the patients belonged to stage IIB. Patients were followed up among whom lymphedema was the predominant symptom which was seen in approximately 25% of the clientele and persisted even at the end of 24 months. Pain and shoulder stiffness rapidly recovered over time with minimal disability.

Conclusion:

Those patients who are considered for level III LN dissection should be counselled about the increased risk of associated disability especially ipsilateral lymphedema, which is most evident after one year.
Individualised Lifestyle Intervention in Polycystic Ovarian Syndrome Women Who Desire Fertility: A Feasibility Study
Authors: Koduri Parisuddharao , Parimala Chinta , Kunjummen Aleyamma Thayparmbil , Yadav Bijesh Kumar , Kapoor Nitin , Sandhiya P. , Vimala  , Kamath Mohan Shashikant
Published: September 2024

Background:

Polycystic ovarian syndrome (PCOS) is one of the common causes of anovulatory infertility among women in the reproductive age group. Women with PCOS and obesity often have difficulty in conceiving, and they are more prone for developing metabolic syndrome. Lifestyle modification plays a key role in women with PCOS, who are overweight or obese and is recommended as a first line management option. The earlier trials evaluating the role of lifestyle intervention in infertile PCOS women had methodological issues, smaller sample size and high dropout rates and none of these trials reported live birth as their outcome.

Aim:

The current study was planned to explore the feasibility of conducting large adequately powered multicentric trial in future in South Asian women with PCOS who desire fertility. Setting and Design: The study was done in the Department of Reproductive Medicine and Surgery & the Department of Endocrinology and Metabolism at a university level tertiary care hospital. The study is an open label, single center, randomized controlled trial.

Materials and Methods:

A total of 60 PCOS women aged between 18-40 years with body mass index of > 23 kg/m2 who desire fertility, were randomized to individualized lifestyle intervention and usual care. The primary outcome was the dropout rate, and the secondary outcomes were change in body weight, anthropometric parameters, clinical pregnancy rates and the quality of life specific to PCOS after the trial period. All the participants were followed up for 6 months and the outcomes were assessed.

Statistical Analysis:

Comparison between the intervention and control groups was done using statistical tests using the SPSS and R software.

Results:

The dropout rates were significantly higher in the individualized lifestyle intervention arm compared to usual care control arm (19/30, 63% vs 9/30, 30%, P=0.019). We did not find any statistically significant difference in anthropometric measurements, pregnancy rates (P=0.57) and clinical pregnancy rates (P=0.21) and quality of life specific to PCOS compared with sixth month visit from baseline visit.

Conclusion:

The current feasibility study showed significantly higher dropout rates in individualized lifestyle intervention arm compared to usual care control arm. The knowledge gained from the feasibility study has been used to design an adequately powered trial to evaluate effectiveness of individualized lifestyle intervention in women with PCOS who wish to conceive.
Topical Medroxyprogesterone Acetate and Corneal Epithelium Healing after Photorefractive Keratectomy: A Randomized, Double-masked Contralateral Eye Study
Authors: Peyman Alireza , Pourazizi Mohsen , Irajpour Matin , Noorshargh Pegah , Aslani Asieh
Published: September 2024

ABSTRACT

Objective:

The objective of the study was to evaluate the efficacy and safety of topical 1% medroxyprogesterone in corneal epithelial healing after photorefractive keratectomy (PRK).

Methods:

In this placebo-controlled double-masked randomized contralateral eye study, 66 eyes of 33 patients with myopia and myopia-astigmatism were assigned into two groups to receive either 1% topical medroxyprogesterone (intervention) or artificial tear (placebo) at the end of PRK surgery. The patients were followed up daily for 5 days until epithelial healing was achieved. The time taken for epithelial healing was the main outcome measure.

Findings:

The mean age of the subjects was 32.97 ± 7.6 years and 46 individuals were female (69.7%). All baseline refractive characteristics were comparable between the groups. There was no significant difference between the two groups in terms of epithelial defect size on Day 1 (P: 0.67). Both groups exhibited a consistent pattern of decreasing epithelial defect size from Day 1 to Day 5, with the control group having slightly worse initial values. There were no significant differences between the groups in the following days. Both groups showed substantial reductions in the epithelial defect size, but the intervention group showed a more prominent decrease on Day 2. The intervention did not show a significant statistical difference compared to the control group, and both groups ended up with a similar outcome.

Conclusion:

These findings suggest that the topical 1% medroxyprogesterone does not significantly affect the healing of corneal epithelium after PRK.
Visual parameter status as a predictive factor for the outcomes of occlusion therapy in anisometropic amblyopia
Authors: Palani Subashree , Rangasami Sathiskumar , Baskaran Antony A.
Published: September 2024

PURPOSE:

The purpose is to compare visual parameters between normal and amblyopic eyes in anisometropic amblyopia and to find predictive factors for occlusion therapy.

METHODS:

Sixty patients with anisometropic amblyopia between the ages of 5 and 25 years were enrolled in the prospective, longitudinal, and interventional study. Patients were selected based on no improvement with spectacle correction alone after 1 month of follow-up. Baseline parameters such as LogMAR visual acuity, LEA contrast sensitivity, TNO stereopsis test, online Farnsworth D-15 test for color vision, accommodation with RAF ruler, +2.00/-2.00 flipper test, and dynamic retinoscopy were recorded. All patients were treated with occlusion therapy depending on their grades of amblyopia. After 6 months of follow-up, improvement in visual acuity was recorded with a LogMAR chart and correlated with initial visual parameters. Paired “t” test, Chi-square test, independent “t” test, analysis of variance test were used as statistical analysis.

RESULTS:

Visual functions such as contrast sensitivity, accommodative facility, near point of accommodation, and accommodative amplitude showed a statistically significant difference between normal and amblyopic eyes of anisometropic amblyopia patients, whereas color vision did not differ significantly between normal and amblyopic eyes. Sixty-seven percentage of patients had poor stereopsis. Eighty percentage of patients who were younger had improvement in final best-corrected visual acuity and these patients had better stereopsis, contrast sensitivity, and mild-to-moderate amblyopia on initial testing.

CONCLUSION:

The age of the patient, degree of anisometropia, spherical equivalent in amblyopic eyes, stereopsis, contrast sensitivity values at initial presentation, and compliance to occlusion therapy were found to be positive predictive factors of occlusion therapy.
Evaluation of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and mean platelet volume levels in pediatric keratoconus patients
Authors: Toprak Müge , Altıntaş Özgül , Sezer Özge Y. , Yılmaz Tuğan Büşra
Published: September 2024

PURPOSE:

To examine the level of neutrophil–lymphocyte ratio and platelet-lymphocyte ratio in the pediatric patient group with keratoconus.

METHODS:

Patients aged 5–18 years with a diagnosis of keratoconus followed by the corneal department and children in the similar age group who were determined as controls were included in the study. Their topographies were evaluated. In both groups, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and mean platelet volume (MPV) were measured.

RESULTS:

The study group consisted of children aged 15 ± 1.4 years and the control group 13 ± 1.3 years of age. The mean central corneal thickness of the patients in the patient group was 445.64 μm, and in the control group was 532.25 μm. The NLR was 3.37 ± 1.04 in the patient group and 2.31 ± 0.82 in the control group. The PLR was significantly increased in the KC group (147.54 ± 41.36) than in the control group (118.71 ± 27.11) (P = 0.042). MPV in the patient group was 12.18 ± 2.76 and 7.00 ± 1.37 in the control group. This value was found to be statistically significant (P = 0.047) when the control group and the patient group were compared.

CONCLUSION:

Platelet/lymphocyte ratio and mean platelet volume, which are thought to be new markers of systemic inflammation, may be new indices in keratoconus in pediatric patients.
Ocular findings in the evaluation of abusive head trauma in children
Authors: Alswayed Sarah K. , Aldharman Sarah S. , Alraddadi Jumanah S. , Almuneef Maha , Aldibasi Omar , Alfreihi Shatha
Published: September 2024

PURPOSE:

Abusive head trauma (AHT) is a form of child physical abuse that can result in major ocular injuries. This study describes the clinical presentation and ocular manifestations of infants diagnosed with AHT in a tertiary care center in Saudi Arabia.

METHODS:

This is an observational, retrospective, cross-sectional study from 2015 to 2022 conducted at King Abdullah Specialized Children’s Hospital (KASCH) in Riyadh, Saudi Arabia. Inclusion criteria include infants <2 years of age, diagnosed with AHT that had an eye examination as part of the evaluation.

RESULTS:

A total of 25 (50 eyes) cases of AHT had an eye examination documented in the electronic patients’ records. The majority were males 19 (76%), and <6 months of age 10 (40%). About half of the children were healthy 13 (52%), and 12 (48%) had underlying physical illness. All patients had computed tomography scans. Subdural bleeding was noted in 22 (88%), 1 (4%) had epidural, and 4 (16%) had subarachnoid bleed. External ocular signs were noted in 8 (32%) patients only, including raccoon eyes, periorbital bruises, subconjunctival hemorrhage, and nonfixating eyes. Fundus findings were bilateral in 18 (72%), unilateral in 2 (8%), and normal in 5 (20%). In those with findings, the majority of 34 (68%) eyes had multiple retinal hemorrhages, 4 (8%) had vitreous hemorrhages, 2 (4%) retinal detachments, and 1 (2%) retinoschisis.

CONCLUSION:

Fundus examination is an important part of the comprehensive examination of children with suspected AHT; the majority of patients had an abnormal fundus examination with the tendency of bilateral findings.
Urgent need for prognostic markers for hepatocellular carcinoma in the light of genomic instability and non-coding RNA signatures
Authors: Velikova Tsvetelina , Gulinac Milena
Published: September 2024

In this editorial, we comment on an original article by Duan et al . Despite advancements in the diagnosis and treatment of hepatocellular carcinoma (HCC), the identification of suitable prognostic factors remains challenging. In their paper, Duan et al identified long non-coding RNAs (LncRNAs) to quantify genomic instability (GI) by combining LncRNA expression and somatic mutation profiles. They confirmed that the GI-derived LncRNA signature (GI-LncSig) could be an independent prognostic factor with the area under the curve of 0.773. Furthermore, the authors stated that GI-LncSig may have a better predictive performance than TP53 mutation status alone. However, studies exploring genetic markers for predicting the prognosis of HCC are crucial for identifying therapeutic targets and enhancing diagnostic and treatment strategies to mitigate the global burden of liver cancer.
Advancing perioperative optimization in Crohn's disease surgery with machine learning predictions
Authors: Nardone Olga Maria , Castiglione Fabiana , Maurea Simone
Published: September 2024

This editorial offers commentary on the article which aimed to forecast the likelihood of short-term major postoperative complications (Clavien-Dindo grade ≥ III), including anastomotic fistula, intra-abdominal sepsis, bleeding, and intestinal obstruction within 30 days, as well as prolonged hospital stays following ileocecal resection in patients with Crohn’s disease (CD). This prediction relied on a machine learning (ML) model trained on a cohort that integrated a nomogram predictive model derived from logistic regression analysis and a random forest (RF) model. Both the nomogram and RF showed good performance, with the RF model demonstrating superior predictive ability. Key variables identified as potentially critical include a preoperative CD activity index ≥ 220, low preoperative serum albumin levels, and prolonged operation duration. Applying ML approaches to predict surgical recurrence have the potential to enhance patient risk stratification and facilitate the development of preoperative optimization strategies, ultimately aiming to improve post-surgical outcomes. However, there is still room for improvement, particularly by the inclusion of additional relevant clinical parameters, consideration of medical therapies, and potentially integrating molecular biomarkers in future research efforts.
Three-dimensional printing for preoperative rehearsal and intraoperative navigation during laparoscopic rectal cancer surgery with left colic artery preservation
Authors: Zhao Zong-Xian , Hu Zong-Ju , Yao Run-Dong , Su Xin-Yu , Zhu Shu , Sun Jie , Yao Yuan
Published: September 2024

BACKGROUND

Prior studies have shown that preserving the left colic artery (LCA) during laparoscopic radical resection for rectal cancer (RC) can reduce the occurrence of anastomotic leakage (AL), without compromising oncological outcomes. However, anatomical variations in the branches of the inferior mesenteric artery (IMA) and LCA present significant surgical challenges. In this study, we present our novel three dimensional (3D) printed IMA model designed to facilitate preoperative rehearsal and intraoperative navigation to analyze its impact on surgical safety.

AIM

To investigate the effect of 3D IMA models on preserving the LCA during RC surgery.

METHODS

We retrospectively collected clinical dates from patients with RC who underwent laparoscopic radical resection from January 2022 to May 2024 at Fuyang People’s Hospital. Patients were divided into the 3D printing and control groups for statistical analysis of perioperative characteristics.

RESULTS

The 3D printing observation group comprised of 72 patients, while the control group comprised 68 patients. The operation time (174.5 ± 38.2 minutes vs 198.5 ± 49.6 minutes, P = 0.002), intraoperative blood loss (43.9 ± 31.3 mL vs 58.2 ± 30.8 mL, P = 0.005), duration of hospitalization (13.1 ± 3.1 days vs 15.9 ± 5.6 days, P < 0.001), postoperative recovery time (8.6 ± 2.6 days vs 10.5 ± 4.9 days, P = 0.007), and the postoperative complication rate (P < 0.05) were all significantly lower in the observation group.

CONCLUSION

Utilization of a 3D-printed IMA model in laparoscopic radical resection of RC can assist surgeons in understanding the LCA anatomy preoperatively, thereby reducing intraoperative bleeding and shortening operating time, demonstrating better clinical application potential.
Development of a novel difficulty scoring system for laparoscopic liver resection procedure in patients with intrahepatic duct stones
Authors: Luo Bo , Wu Si-Kai , Zhang Ke , Wang Pei-Hong , Chen Wei-Wei , Fu Ning , Yang Zhi-Ming , Hao Jing-Cheng
Published: September 2024

BACKGROUND

For intrahepatic duct (IHD) stones, laparoscopic liver resection (LLR) is currently a reliable treatment. However, the current LLR difficulty scoring system (DSS) is only available for patients with hepatocellular carcinoma.

AIM

To explore the development of a DSS for IHD stone patients with LLR and the validation of its reliability.

METHODS

We used clinical data from 80 patients who received LLR for IHD stones. Forty-six of these patients were used in multiple linear regression to construct a scoring system. Another 34 patients from different centers were used as external validation. The completeness of our DSS was then evaluated in patients with varying degrees of surgical difficulty based on documented surgical outcomes in the study group of patients.

RESULTS

The following five predictors were ultimately included and scored by calculating the weighted contribution of each factor to the prediction of operative time in the training cohort: Location of stones, number of stones ≥ 3, stones located in the bile ducts of several grades, previous biliary surgery less than twice, distal bile duct atrophy. Subsequently, the data set was validated using a DSS developed from the variables. The following variables were identified as statistically significant in external validation: Operative time, blood loss, intraoperative transfusion, postoperative alanine aminotransferase, and Clavien-Dindo grading ≥ 3. These variables demonstrated statistically significant differences in patients with three or more grades.

CONCLUSION

Patients with IHD stones have varying degrees of surgical difficulty, and the newly developed DSS can be validated with external data to effectively predict risks and complications after LLR surgery.
Impact of fast-track surgery on perioperative care in patients undergoing hepatobiliary surgery
Authors: Wang Xiao-Hong , Chen Fang-Fang , Pan Jia , Jiang Yun-Fei , Yao Min-Yue , Mao Jia-Li , Xu Ya-Feng
Published: September 2024

BACKGROUND

Fast-track surgery (FTS) is a modern nursing approach that has gained popularity in the perioperative phase of surgery.

AIM

To investigate the impact of FTS on perioperative care for hepatobiliary surgery.

METHODS

A retrospective analysis was performed on 98 patients who underwent hepatobiliary surgery and were admitted to our hospital from August 2021 to October 2023. They were divided into an observation group and a control group with 49 patients in each group according to different nursing directions. The control group was treated with standard nursing and the observation group was treated with FTS concept nursing. The length of hospital stay, visual analog scale (VAS) score, wound complications, nursing satisfaction, self-rating scale (SAS) score, and SF-36 quality of life (QoL) score were compared between the two groups before and after care.

RESULTS

The duration of hospitalization, hospitalization cost, operation time, first implantation time, exhaust time, and first defecation time were shorter than the observation group (P < 0.05). Additionally, the observation group showed a significant difference between the VAS and SAS scores on days 1, 3, and 7 (P < 0.05). The complication rate in the observation group was 4.05% was significantly lower than the 18.36% in the control group, and the comparison groups were statistically significant (χ 2 = 5.018, P = 0.025). The observation group had a significantly higher level of nurse satisfaction (94.92%) than the control group (79.59%; χ 2 = 6.078, P = 0.014). Both groups showed higher QoL scores after nursing care, with higher scores in the observation group than in the control group (P = 0.032).

CONCLUSION

FTS in patients undergoing hepatobiliary surgery can effectively improve negative mood, QoL, and nursing satisfaction; reduce wound complications; and accelerate patient rehabilitation.