bluuebunny/crossref_metadata_2025 huggingface dataset:
The investigation of the frequency of COVID-19 in patients with a history of stroke
Authors: Aghamiri Seyed H. , Mafi Ahmad R. , Haghighi Mehrdad , Ghaffari Mehran , Karimzadeh Afshin
Published: May 2024

ABSTRACT

Introduction:

The emergence of the coronavirus in 2019 became a global epidemic disease. According to the World Health Organization, people with a history of chronic diseases such as brain stroke are among the main groups at risk of contracting COVID-19. Therefore, this study was performed with the aim of the determination amount of the frequency of contracting COVID-19 in stroke patients.

Materials and Methods:

This descriptive-analytical study was conducted on 100 patients with a history of stroke referred to Imam Hossein Hospital in Tehran (Iran) between 2019 and 2022, which had all the inclusion criteria in the study. The demographic information including (gender, weight, height) and clinical information was collected by a researcher-made questionnaire and analyzed by SPSS version 24 software.

Results:

The average age of the studied patients was 63 years. Among them, 53 people (53%) were infected with COVID-19. The most of underlying diseases were related to high blood pressure. All cases of stroke in patients with COVID-19 were associated with thrombotic type, and half of the other cases included involvement in large cerebral vessels. Lymphocyte count, CRP, and ESR levels were relatively higher in stroke patients with COVID-19, but there were observed no cases of pleural effusion and pericardial effusion associated with COVID-19 in stroke patients. In all of the patients with COVID-19, pulmonary involvement was observed in the Peripheral/Perihillar area.

Discussion and Conclusion:

According to the results and data of this research, the probability of infecting COVID-19 is higher in people with a history of stroke, and these patients have more severe strokes and more mortality than stroke patients without contracting COVID-19.
Improvement of knowledge following diabetes self-management education with respect to socioeconomic status: A retrospective cohort study among type 2 diabetes in Eastern India
Authors: Majumder Anirban , Mukherjee Poulomi , Chakraborty Soma , Chaudhuri Soumyabrata Roy , Chakraborty Sumanta
Published: May 2024

ABSTRACT

Introduction:

We assessed the baseline knowledge and the improvement and retention of knowledge after attending diabetes self-management education (DSME) programs with respect to different socioeconomic status (SES). We also looked into the change in body mass index (BMI), blood pressure, and glycemic parameters after attending the DSME sessions.

Materials and Methods:

This was a retrospective, cohort study carried out via chart review based on data collected from manual or electronic medical records (EMR) and questionnaire responses of 160 adult patients with type 2 diabetes (T2D) who attended two DSME sessions with a gap of at least six months.

Results:

Baseline knowledge on diabetes was uniform (P = 0.06), irrespective of differences in SES, and DSME sessions significantly improved the knowledge in all socioeconomic classes (P value < 0.05 in each SES group). However, SES did have a significant influence on the finally acquired knowledge of diabetes as was evident from the final score after attending two DSME sessions. A significant number of patients (48.1%) from our cohort either improved or retained their knowledge of diabetes over a mean follow-up of 15.5 months. The BMI of our cohort was significantly reduced from baseline to final follow-up (P = 0.016).

Conclusion:

DSME sessions were effective in improving knowledge and awareness among T2D patients, irrespective of socioeconomic classes in Eastern India. The acquired knowledge from DSME sessions was retained over a long time.
Comparison of routine office blood pressure measurement versus standardized attended manually activated oscillometric office blood pressure measurement in patients with chronic kidney disease
Authors: Chellappan Anand , Kansal Keshiha
Published: May 2024

ABSTRACT

Context:

Erroneous blood pressure measurement could lead to improper treatment and hence progression of chronic kidney disease (CKD). In routine clinical practice, there is poor adherence to the various steps to be followed during blood pressure measurement. Automated oscillometric BP measurement is difficult to perform in routine clinical practice due to several practical limitations.

Aims:

To evaluate the quality of blood pressure measurement and to compare routine office blood pressure measurement with standardized attended manually activated oscillometric blood pressure measurement in patients with CKD attending the nephrology outpatient department (OPD) of a tertiary care referral center.

Settings and Design:

This cross-sectional study was conducted in patients aged more than 18 years with CKD stage 3–5ND, and previously diagnosed hypertension, in the nephrology OPD of a tertiary care referral center between July 2022 and September 2022.

Methods and Material:

The quality of blood pressure measurement was evaluated using a questionnaire. The study participants had their blood pressure checked by both methods—routine office blood pressure and standardized attended manually activated oscillometric blood pressure.

Results:

Standardized attended manually activated oscillometric blood pressure measurement yielded a significantly higher systolic blood pressure (SBP) compared to routine office blood pressure measurement (Mean SBP: 139.53 ± 29.1 vs 132.57 ± 23.59; P < 0.001). However, the diastolic blood pressure did not differ significantly between the two methods of measurement.

Conclusions:

Standardized attended manually activated oscillometric BP measurement yields a higher systolic BP compared to routine office BP measurement. Further studies are required to compare the standardized attended oscillometric BP measurement used in this study with unattended automated oscillometric BP measurement and ambulatory BP measurement.
Association between the Hopkins Falls grading scale and motor function tests in patients with multiple sclerosis
Authors: Mashoufi Rasam , Nahayati Mohammad A. , Meshkat Mojtaba , Ebrahimi Seyed A. , Salimi Mostafa , Yekta Maryam M. , Alehashemi Alireza
Published: May 2024

ABSTRACT

Introduction:

One of the main complications of multiple sclerosis (MS) is imbalance and walking problems that can lead to falls. This study investigated the association between a fall measurement scale called the Hopkins Falls Grading Scale (HFGS) and motor function tests in patients with MS.

Material and Methods:

This cross sectional study was conducted using convenience sampling on 85 patients referred to the MS Association of Mashhad, Iran, in 2023. The HFGS examined falls during the past year and divided them into 4 degrees, and the function test included the timed 25 foot walk (T25FW) test and the timed up and go (TUG) test. Kruskal–Wallis test and Spearman’s correlation coefficient were used for data analysis.

Results:

A statistically significant association was obtained between HFGS and functional tests (T25FW and TUG) (for both P < 0.0001). A significant association was observed between the variables of age (P = 0.006), duration of the disease (P = 0.03), the use of mobility devices (P = 0.05), and HFGS.

Conclusion:

Considering the association between HFGS and motor function tests in MS patients, clinical experts should pay attention to patients who have slower movement and evaluate them in terms of falling status when performing motor function tests.
Cognitive facet and paradigm of the caregivers of children with developmental problems in Eastern India
Authors: De Partha , Chatterjee Nandita , Pal Ranabir , Ghosh Amrita
Published: May 2024

ABSTRACT

Background:

The role of caregivers in grooming the neuro-developmental outcome of high-risk newborns and developmental challenges in children needs to be explored.

Objectives:

To find the knowledge and perception among parents regarding the neuro-developmental outcome of high-risk newborns, methods adopted to address these problems, and to identify areas on which awareness generation needs to focus.

Materials and Methods:

A questionnaire-based awareness survey was conducted to understand the knowledge, attitude, and practices of families of children with developmental challenges.

Results:

The study revealed that more than 70 percent of families lack information about child development, developmental challenges, and means to deal with them. They are unaware of the available health care services and other resources. One in three families has misconceptions on developmental disabilities; consider them as curse or jinx and consequently neglected. Female children with developmental problems are further ostracized due to gender inequity in families. About 10 percent of families have shown great openness toward acquiring new skills and knowledge for handling their children with developmental delays.

Conclusions:

This study is based on the précis research findings of our grass-root level fieldwork conducted in remote rural Bengal areas. The observation will be of interest and learning materials for general primary care practitioners, family physicians, and stakeholders to initiate appropriate intervention strategies for properly rehabilitating children with developmental delay at grass-root levels of primary health care.
Socio-demographic association with confirmed hepatitis C virus infection: A cross-sectional analysis from a teaching institute
Authors: Medhi Mithu , Sonowal Aparna , Sonowal Pranjal , Neog Bhaskar Jyoti , Phukan Chimanjita
Published: May 2024

ABSTRACT

Introduction:

Hepatitis C virus (HCV) infection is the most common chronic blood-borne disease and is more commonly associated with chronic active hepatitis leading to cirrhosis, hepato-cellular carcinoma and end-stage liver disease.

Methodology:

160 consecutive screening positive (Enzyme linked immuno sorbent assay positive) Hepatitis C samples were tested by HCV RNA Real Time-PCR for confirmation.

Result:

Prevalence of confirmed hepatitis C among screening positive patient in the present study was found to be 24.4%. Vaccinated individual with Hepatitis A and Hepatitis B had significant association with PCR positivity in screening positive Hepatitis C patient (p< 0.05). IV drug users and patient having multiple sex partners have significant association with PCR positivity among screening positive Hepatitis C patients (p< 0.05).

Conclusion:

Due to the lack of an effective vaccine and the increased risk of serious complications, it is important to focus on prevention and early detection of HCV.
Controversial aspects of Pashanabheda in classical texts of Ayurveda
Authors: Rabadiya Mital G , Sharma Tarun , Nathani Sumit
Published: May 2024

Background

Ayurveda is an Indian traditional system of medicine. In the present era, the world is looking towards herbal medicine for its acceptability and safety. There are some medicinal plants in Ayurveda that are used across India under different local names and different botanical species. Pashanabheda is one among them, which is used in ashmari, basti shodhana, mutrakrichha, yoni roga, prameha, etc., and many different species are used under the name Pashanabheda.

Purpose

The purpose of this study is to find out the correct botanical identity of Pashanabheda based on the characteristics, effects, properties, and therapeutic uses mentioned in our classical texts.

Materials and Methods

Classical texts of Ayurveda, such as Samhita and Nighantu, other texts related to botany, taxonomy, and various scientific research articles as well as online search engines were reviewed and information was systematically collected, compared, and presented.

Result

Bergenia ligulata Wall., Aerva lanata Juss., Coleus aromaticus Benth., Kalanchoe pinnata (Linn.), Ammania baccifera Linn., Rotula aquatica Lour., Homonoia riparia Lour., and Bridelia retusa Spreng. are abundantly used under the name Pashanabheda in different regions of the country. We compared the effects, properties, and therapeutic indications of all species. After considering the botanical description, habitat, synonyms, and comparative analysis of effects and therapeutic indications of the various species, Berginia ligulata seems to be more appropriate and should be used as Pashanabheda.

Conclusion

It is concluded that Bergenia ligulata is widely acceptable for Pashanabheda. Aerva lanata, Coleus aromaticus, and several other diuretic plants are usually recommended to be used instead, but the habitat (growing among the rocks) and the clinical efficiency of Bergenia in dissolving the stones formed in the urinary tract fully justify the use of various names attributed to it.
Speed versus Sensitivity
Authors: Sharma Apoorva , Karade Santosh , Anand Kavita Bala , Lall Mahima , Sen Sourav , Patrikar Seema , Naithani Nardeep
Published: May 2024

Background:

As the world battles the coronavirus disease 2019 (COVID-19) pandemic, rapid detection is the key to contain the spread of the disease. Although real-time polymerase chain reaction (RT-PCR) remains the gold standard for the diagnosis of severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) infection, it demands specialized equipment and technical expertise. SARS-CoV-2 rapid antigen detection test (RAT) is the user-friendly alternative, which needs evaluation in the hospital setting.

Materials and Methods:

This cross-sectional study was carried out at the Indian Council of Medical Research approved COVID-19 diagnostic molecular laboratory between November and December 2020. Nasopharyngeal swabs in viral transport medium (VTM) were received from suspected SARS-CoV-2 infected individuals were processed for SARS-CoV-2 RT-PCR and a rapid antigen detection test, COVID-19 Ag Respi-Strip.

Results:

A total of 342 samples were assessed for this study by RT-PCR and Rapid Antigen Test. The sensitivity of RAT was found to be 41% at an RT-PCR cycle threshold of 35 or below. Sensitivity of RAT improved to 81.2% when a RT-PCR cycle threshold of 25 or below was considered as positive. Specificity of RAT was 99% to 100%.

Conclusion:

Rapid antigen test is a cost-effective alternative for screening of symptomatic individuals in the hospital setting. However, due to low sensitivity, the negative results need to be interpreted with caution.
Estimating the usefulness of inferior vena cava collapsibility index and caval aorta index to predict hypotension after spinal anaesthesia in adult patients undergoing elective surgery in a tertiary care hospital
Authors: Eeshwar MV , Chari Alankrita , Gaude Yogesh K. , Kordcal Abhishek Rao
Published: May 2024

Background and Aims:

Post-spinal anaesthesia hypotension (PSAH) can occur in 25–75% of patients. The preload or volume status of a patient is an important contributor to PSAH, and coloading with fluids is advocated to prevent PSAH. Instead of blind volume loading, prediction of volume status using inferior vena cava (IVC) collapsibility index (IVCCI) and caval aorta index (IVC:Ao index) may be used to guide fluid administration.

Material and Methods:

In our study, we used ultrasound in the immediate pre-operative period to calculate IVCCI and IVC:Ao index in patients scheduled for elective surgery in the supine position, under spinal anaesthesia. Spinal anaesthesia was given in the lateral position with 0.5% hyperbaric bupivacaine. Patients were placed supine thereafter, sensory blockade level was ascertained, and blood pressure (BP) was measured every 2 min for 30 min. Episodes of hypotension were treated with fluids or vasopressors as per the discretion of the treating anaesthesiologist. In the study, 73 patients were screened, out of which 69 were included.

Results:

Totally, 23 participants out of 69 developed PSAH. The receiver operating characteristic (ROC) curve was made and the area under the curve analysis was done on our collected data. We found that IVC:Ao index has better sensitivity (0.696 for IVC:Ao index ≤0.810) and specificity (0.717 for IVC:Ao index ≤0.810) than IVCCI (sensitivity 0.522 and specificity 0.630 for IVCCI ≥33.32%) to predict PSAH.

Conclusion:

IVC:Ao index is a better predictor of PSAH than IVCCI. Thus, it may be used to predict volume status and guide in coloading with fluids during spinal anaesthesia.
Effect of single-dose intravenous lignocaine versus fentanyl on neuromuscular recovery time after general anesthesia in elective pediatric surgery: A randomized controlled pilot study
Authors: Dhar Mridul , Sharma Ruhi , Payal Yashwant S. , Gupta Vaishali , Rawat Jyoti , Sogal Sachin
Published: May 2024

Background and Aims:

Intravenous (IV) lignocaine is often used to prevent the airway response to extubation, especially in children to prevent respiratory adverse events. It is known to prolong the duration of action of neuromuscular blocking drugs, but data in children are limited. The primary objective of this study was to compare neuromuscular recovery time with IV lignocaine versus fentanyl, in pediatric patients undergoing elective surgery under general anesthesia (GA). Secondary objectives included the comparison of clinical parameters and respiratory complications.

Material and Methods:

A randomized double-blind pilot study was conducted in 42 children aged 2–8 years undergoing GA with neuromuscular blockade, who received either 1.5 mg/kg of lignocaine or 0.5 mcg/kg of fentanyl IV, just prior to giving reversal at a train of four (TOF) count of 2–3. Time to achieve a TOF ratio of 0.9 and extubation and hemodynamic and respiratory parameters were noted. Incidences of coughing, bucking, laryngospasm, etc., were also noted. P value < 0.05 was considered significant.

Results:

Demographic and operative data were similar. Time from reversal to TOF ratio of 0.9 was similar with both lignocaine (6.79 ± 3.03 mins) and fentanyl (6.79 ± 3.31 mins), P = 0.99. Time to extubation was also similar in both groups (8.14 ± 3.31 vs 9.19 ± 2.89 min), P = 0.28. Bucking incidence was higher with fentanyl (23.8%) vs lignocaine (9.5%), P = 0.41.

Conclusions:

Single-dose IV lignocaine administered before reversal did not prolong neuromuscular recovery time compared to fentanyl, with a similar (low) incidence of respiratory events in pediatric patients.
A Comparative Study of Conjunctival-Limbal Autograft with Fibrin Clot and Glue Techniques for Pterygium
Authors: Gonugunta Vishnu Teja , Jha Kirti Nath , Srikanth Krishnagopal , Pabolu Chinmayee
Published: May 2024

Introduction:

Pterygium is a common conjunctival disorder seen in tropical countries. Surgery is the permanent treatment. Various methods of graft fixation include sutures, fibrin clot, and glue techniques. Fibrin clot (autologous serum) technique involves the utilization of the patient's oozed blood from the episcleral vessels to serve as natural glue adhering the graft to the underlying sclera, whereas commercial glue involves the use of two components for firm adherence of the graft.

Aim:

The aim of this study is to observe and compare the complication rates, outcomes, and recurrence with fibrin clot and glue techniques for pterygium.

Materials and Methods:

One hundred and twenty-six eyes of 126 patients with primary pterygium were operated under peribulbar anesthesia by a single surgeon after doing the routine clinical examination. Group A included 63 eyes where the fibrin clot technique was used for graft adherence and Group B included 63 eyes where commercial glue was used for fixing the graft. Pterygium was excised, and a conjunctival-limbal autograft was taken from the superior bulbar conjunctiva of the same eye. In the fibrin clot (autologous serum) technique, natural hemostasis was encouraged, and the graft was placed over the oozed blood, left undisturbed for 10 min. In the glue technique, hemostasis was achieved and graft was transplanted over the glue and left undisturbed for 2 min. Eye patch was removed the next day of surgery. Preoperative and postoperative photographs were taken. Standard postoperative treatment was given. Follow-up was carried on day (postoperative day) 1, 15, 30, 90, 180, and 300.

Results:

The mean surgical time was 29.3 and 19.6 min in Group A and Group B, respectively. Graft retraction and graft edema were noted in four patients (6.3%) in fibrin clot technique, and graft edema was noted in five patients (7.9%) in Group B, which resolved on subsequent visits with conservative management. No recurrence was noted in either group. No other postoperative complications were noted in both groups.

Conclusion:

Fibrin clot (autologous serum) and glue techniques do not use sutures, thus avoid the cost of sutures and suture-related discomfort and complications. Fibrin clot (autologous serum) is more economical than the glue technique. Cosmetic outcome in the immediate postoperative period is better with glue than fibrin clot technique. Long-term outcome is the same in both groups. Autologous serum avoids the transmission of prion diseases possible with glue method. Both the techniques are equally safe and efficient.
Addressing Obesity and Dental Caries: Rationale and Practical Guidelines, a Narrative Review
Authors: Alnassar Faisal , Alnassar Waleed , Chikkanna Meenakumari , Gaballah Olfat Mohamed , Moawad Amira A.R. , Krishnan Ramesh , Jandrajupalli Suresh Babu , Chandolu Swarnalatha
Published: May 2024

Obesity is a chronic disease with global, epidemic spread. The worldwide prevalence of obesity is a considerable source of concern, given its potential impact on morbidity, mortality, and cost of health care. The World Health Organization (WHO) has recognized obesity as a predisposing factor to major chronic diseases ranging from cardiovascular diseases to cancers. Once considered a problem only in developed nations, the WHO estimates now show that obesity is on the rise, dramatically, even in low- and middle-income countries. Both obesity and dental caries have common determinants and require a comprehensive, integrated, and multidisciplinary approach. In this context, dental health-care professionals should promote healthy diets not only to prevent dental caries but also to reduce the risk of obesity, provided that obesity and dental caries share common lifestyle factors starting from childhood and adolescence. There are very few literature evidences wherein significant attention has been drawn toward the prevention of this global health burden. The present review focuses on a similar lacuna in the literature and emphasizes the role of primary health-care providers including dental professionals who are well-trained to address this public health concern at grassroots levels. Thus, the improvement of dental health and general well-being of individuals requires an active collaboration between dental and general health-care providers and the implementation of health promotion strategies targeting management of both obesity and dental caries by using a holistic approach.
Anterior Ethmoid Roof Configuration: A Computed Tomography Scan Analysis of Adult Nigerians with Chronic Rhinosinusitis
Authors: Kolo Emmanuel Sara , Abdullahi Hamisu
Published: May 2024

Context:

The anterior skull base has been adjudged a high-risk area in endoscopic sinus and skull base surgery. Hence, an understanding of its complex anatomy is crucial if catastrophic intra-operative complications must be avoided.

Aims:

To identify the anatomical configurations of the anterior skull base by radiological analysis, and to determine the prevalence of its variations among adults with chronic rhinosinusitis.

Settings and Design:

A retrospective study of 99 adult patients with chronic rhinosinusitis who attended the Ear Nose and Throat clinic of Aminu Kano Teaching Hospital from July 2022 to June 2023.

Methods and Materials:

The patient’s records were retrieved, and the basic demographic data, clinical history, and examination findings were extracted. All patients had diagnostic nasal endoscopy, and computed tomography scans of the nose and paranasal sinuses which were analyzed using a computer software program.

Statistical Analysis Used:

The data was analyzed with SPSS version 22.0 using frequency, mean, Pearson Chi-square tests and the results were presented in tables and figures.

Results:

A total of 99 patients’ CT scans were analyzed. There were 61 males (61.6%) and 38 females 38.4%) with a mean age of 31.7 years. 37 (37.4%) and 62 (62.6%) of patients had asymmetry and symmetry in the fovea ethmoidalis respectively. The anterior ethmoid artery was found coursing through the anterior ethmoidal air cells in 73 (36.9%) and along the anterior skull base in 125 patients (63.1%). Kero’s classification showed types I in 140 (70.7%), type II in 54 (27.3%) and type III in 4 (2.0%).

Conclusion:

This study found that a significant proportion of the study population had ethmoid roof asymmetry and the anterior ethmoid artery was found coursing through the anterior ethmoidal air cells respectively.
Onychomycosis: Prevalence, Fungal Pathogens, Risk Factors, and Antifungal Susceptibility Profile among People Living with Diabetes Mellitus in Kano, Northwestern Nigeria
Authors: Idris Amina Muhammad , Hafiz Taysir R. , Getso Muhammad Ibrahim , Umar Maimuna Baffa , Kabuga Auwal Idris
Published: May 2024

Context:

Onychomycosis is a fungal infection of the nail unit that over time results in dystrophy and disfigurement. It affects the quality of life and increases the prevalence and severity of foot ulcers in patients with diabetes.

Aim:

The study investigated the prevalence of onychomycosis, the associated fungal pathogens, and their antifungal susceptibility profile in a cohort of people living with diabetes (PLWDM) in Kano, Nigeria.

Settings and Designs:

This cross-sectional hospital-based study recruited and enrolled 300 PLWDM from two major diabetes treatment centers in Kano.

Materials and Methods:

Participants were screened for thickened, brittle, crumbly, or ragged nails, and 30 met the inclusion criteria. Sociodemographic data, clinical history, and other risk factors for onychomycosis were also evaluated. Toenail and fingernail, nail clippings, and scrapings were collected and cultured on Sabouraud dextrose agar (SDA). The identification of yeasts and mold isolates was performed using gram stain, germ tube test, CHROMagar, lactophenol cotton blue (LPCB) mount, and slide cultures. Antifungal susceptibility testing was achieved by the agar well-diffusion method.

Statistical Analysis Used:

The data generated were analyzed using descriptive statistics and associations between variables checked by the chi-square test or Fisher’s exact test.

Results:

The prevalence of onychomycosis was 63.3% (19/30), and fingernails were mostly affected. Fungal pathogens recovered include dermatophytes, yeasts, and non-dermatophyte molds, with a predominance of Aspergillus spps. (7/19 (36.8%)), Trichophyton
mentagrophytes (4/19 (21.1%)), Trichophyton
rubrum (4/19 (21.1%)), and Candida
albicans (2/19 (10.5%)). A preponderance of the isolates shows a good susceptibility profile to itraconazole, ketoconazole, and clotrimazole, but demonstrated high resistance to fluconazole. Age and use of oral hypoglycemic agents were some of the risk factors identified.

Conclusion:

The study shows a high prevalence of onychomycosis among PLWDM in Kano and calls for routine screening to minimize or eliminate all possible complications.
Malignant Otitis Externa in a Tertiary Hospital, North Central Region of Nigeria: A 15-Year Review
Authors: Segun-Busari Segun , Afolabi Abdulrahman Olushola , Omokanye Habeeb Kayodele , Ayodele Samuel Oluyomi , Dunmade Adekunle David , Sulyman Alabi Biodun , Adeniji Kayode Adebamiji , Braimoh Kolawole Thomas , Fadeyi Abayomi
Published: May 2024

Context:

Malignant otitis externa (MOE) is a rare, rapidly spreading, life-threatening invasive infection of the external auditory canal and the lateral skull base which typically affects elderly patients with diabetes and immunocompromised patients.

Materials and Methods:

Aretrospective review of records of all patients with a diagnosis of malignant otitis external seen at the otorhinolaryngology department over a 15-year period (2007–2021) was seen. Information retrieved included the biodata, the clinical presentation, the treatment modalities, and the outcome of treatment. These were entered into SPSS version 23 and analyzed descriptively.

Results:

A total of 431 case notes with a diagnosis of otitis external were retrieved, but only 18 cases (4.2%) were diagnosed as malignant otitis externa. The age range was between 43 and 90 years (mean age of 65.9 yrs = ±1.2). There were about 7 males and 11 females with an M:F ratio of 1:1.6. Right ear was affected in 62.5%, and left ear in 37.5% of cases. All the patients presented with otalgia (100%), 13 (72.2%) had a history of self-ear cleaning, about 50% presented with otorrhoea, about 37.9% had hearing loss, and 27.8% had facial nerve palsy. Culture results revealed Pseudomonas aeruginosa in 72.2% of the patients sensitive to ciprofloxacin, and they were treated with parenteral and topical ciprofloxacin impregnated with steroids with good outcomes and no mortality.

Conclusion:

Malignant otitis externa affects more female elderly patients with diabetes; the most common presentation was otalgia, with otorrhea with facial nerve involvement in 27.8% palsy, and the most common agent isolated was P. aeruginosa, which responded to parenteral and topical ciprofloxacin impregnated with steroids with no mortality recorded in our study.
Serum Vitamin D Level and Severity of Adult Allergic Rhinitis at a Tertiary Hospital in Northeast Nigeria
Authors: Gwalabe Sabiu A. , Adamu Auwal , Kirfi Abdullahi M. , Dunga Jacob A. , Maigari Ibrahim M. , Umar Mustapha S.
Published: May 2024

Context:

Recent studies have reported abnormal levels of serum vitamin D in patients with allergic rhinitis. This linkage has not been demonstrated in our environment, northeast Nigeria. This study aimed to determine the levels of serum vitamin D and correlate them with disease severity in patients with allergic rhinitis in a tertiary hospital in northeast Nigeria.

Materials and Methods:

This was a cross-sectional observational study of patients with allergic rhinitis who attended ear, nose, and throat and the respiratory medicine clinics of Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria, from January 2022 to May 2023. Data collected from participants included demographic information, clinical findings, and disease severity graded as mild–moderate or severe based on the allergic rhinitis and its impact on asthma WHO 2008 classification. Serum vitamin D levels were measured with an enzyme-linked immunosorbent assay kit.

Results:

The study recruited 61 participants, of whom 39 (63.9%) were women. The mean age (±SD) was 38.66 ± 14.34 years, while the mean serum vitamin D levels (±SD) was 36.65 ± 15.54 ng/ml. Thirteen (21.3%) participants had insufficient serum vitamin D levels below 24 ng/ml, whereas 48 (78.7%) had sufficient serum vitamin D levels of 24–80 ng/ml. There were statistically significant differences between mild and moderate–severe allergic rhinitis with respect to vitamin D level (mean ± SD, 26.73 ± 17.96 vs 38.84 ± 14.24, respectively, 95% CI: −22.06 to −2.16, P = 0.018). There was a significantly positive relationship between serum vitamin D and the severity of allergic rhinitis (χ2 = 8.839, P = 0.003).

Conclusion:

The majority of patients had sufficient levels of serum vitamin D. Higher serum vitamin D was associated with higher severity of allergic rhinitis.
Intraoperative cell salvage transfusion in patients undergoing posterior urethroplasty: Its efficacy of reducing allogeneic blood transfusion, safety, and cost
Authors: Altaweel Waleed , Mehmood Shahbaz , Seyam Raouf
Published: May 2024

Background:

A significant blood loss may be encountered with complex urethroplasty surgery. Blood management aims at reducing allogeneic blood transfusion (ABT) because of limited supply, associated risks, and cost. Intraoperative cell salvage (ICS) has been used in different urological and nonurological surgeries to achieve this goal. However, no study evaluated its role in perineal urethroplasty.

Objectives:

We set out to determine the efficacy of reducing ABT, safety, and cost of ICS in posterior urethroplasty.

Methods:

We reviewed the charts of all patients who underwent posterior urethroplasty between 2012 and 2017. We collected data for patients’ demographics, pre- and postoperative hemoglobin level, ICS volume, complications, equivalent ABT units saved, and cost.

Results:

Seventy patients with a median age of 27.5 ± 10.2 years underwent posterior urethroplasty. Of the 70 patients, 20 (28.57%) required ICS intraoperatively with a median of 441 ml/patient, equivalent to 1.47 units per patient of allogenic blood. No patient needed intraoperative ABT, whereas two patients required transfusions postoperatively. The median pre- and postoperative hemoglobin levels were 124.2 ± 9.2 and 110.3 ± 12.6 g/dl, respectively. There were no significant complications noted while using ICS. There was a 41% cost reduction of equivalent ABT units.

Conclusions:

ICS is safe and effective in reducing ABT during posterior urethroplasty. In our hospital, it is associated with a significant cost reduction of blood transfusion.
Evaluating the construct validity of UroLift simulator through a virtual learning experience of urology residents
Authors: Alzahrani Abdullah Mousa , Alsowayan Ossamah S.
Published: May 2024

Introduction:

Simulations are useful and can mirror the situations needed for skills development. They can have significant impacts on patient safety and help physicians gain proficiency in complex procedures with a short learning curve. They have been validated as an assessment tool and can utilize innovative machines or platforms. Here, we evaluate the construct validity and the performance of residents with different levels using UroLift (NeoTract) simulation.

Methods:

This was a prospective observational study. Two groups of trainees were distributed according to their training level: junior residents and senior residents. Each had to finish three cases of varying difficulties. The data were first tested with the Shapiro–Wilk normality test. Construct validity used an independent sample t-test; P < 0.05 was considered significant.

Results:

Significant differences were seen in performance among junior residents and senior residents in the following skills: proximal centering, mucosal abrasion, and implants in proximal zones. However, insignificant results were seen for number of deployments, successful deployments, lateral suture centering, and implants in the distal zones.

Conclusion:

UroLift simulations are useful for training as a practicing tool. Nevertheless, objective performance evaluation using UroLift simulations requires further steps and frameworks as a source of validity before further result interpretation.
Oncological outcomes of whole-gland cryoablation in patients with prostate cancer and high risk of lymph node invasion
Authors: Selvaggio Oscar , Falagario Ugo Giovanni , Finati Marco , Bruno Salvatore Mariano , Recchia Marco , Milillo Paola , Sanguedolce Francesca , Silecchia Giovanni , Macarini Luca , Cormio Luigi , Carrieri Giuseppe
Published: May 2024

Purpose:

Prostate cryoablation has been proposed as an alternative to radical prostatectomy for men with localized prostate cancer (PCa); however, it is limited by the lack of data regarding oncological outcomes and the impossibility of performing a lymph node dissection. The aim of this study was to assess if whole-gland cryoablation is oncologically safe, especially for patients in whom pelvic lymph node dissection would be necessary.

Materials and Methods:

After institutional review board approval, we identified 102 patients who underwent whole-gland prostate cryoablation between 2013 and April 2019. Lymph node invasion (LNI) probability was computed using Briganti nomogram, and a 5% cutoff probability was used to stratify the population in two groups. Biochemical recurrence after procedure was assessed using Phoenix criteria. Multiparametric magnetic resonance imaging, (CT), and bone scan or choline positron-emission tomography/CT were performed for the detection of distant metastases.

Results:

Seventeen (17%) patients were treated for a low-risk PCa, 48 (47%) patients were at intermediate-risk PCa, and 37 (36%) patients were at high-risk PCa. Patients with a probability of LNI >5% (n = 46) exhibited higher prostate-specific antigen (PSA), PSA density, ISUP Grade Group, CT stage, and european association of urology (EAU) risk. Recurrence-free survival rates at 3 years’ follow-up were 93%, 82%, and 72%, respectively for low-, intermediate-, and high-risk patients. At a median follow-up of 37 months (17–62), additional treatment and metastasis-free survival were 84% and 97%, respectively. No differences in oncological outcomes were found in patients with a probability of LNI above and below 5%.

Conclusions:

Prostate whole-gland cryoablation can be considered a safe procedure with acceptable outcomes in low- and intermediate-risk patients. A high preoperative risk of nodal involvement could not be considered an exclusion criterion to perform cryoablation. Further studies are required.
False-positive magnetic resonance imaging prostate cancer correlates and clinical implications
Authors: Arafa Mostafa A. , Rabah Danny M. , Khan Farrukh , Farhat Karim Hamda , Ibrahim Nahla Khamis , Albekairi Alanoud A.
Published: May 2024

Background:

False-positive (FP) multiparametric magnetic resonance imaging (MPMRI) obscures and swift needless biopsies in men with a high prostate-specific antigen.

Materials and Methods:

This was a retrospective study, in which all patients who had been exposed to consecutive MP-MRI of the prostate combined with transrectal ultrasound-guided-magnetic resonance imaging fusion-guided prostate biopsy between 2017 and 2020 were involved in the study. The FP was measured as the number of biopsies that did not encompass prostate cancer divided by the whole number of biopsies.

Results:

The percentage of FP cases was 51.1%, the highest percentage was found in Prostate Imaging–Reporting and Data System (PI-RADs) 3 (37.7%) and the lowest was detected in PI-RAD 5 (14.5%). Those with FP biopsies are younger, and their total prostate antigen (PSA) and PSA density (PSAD) are significantly lesser. The area under the curve PSAD, age, and total PSA are 0.76, 0.74, and 0.69, respectively. An optimum PSAD value of 0.135 was chosen as a cutoff because it showed the highest sum of sensitivity and specificity, 68% and 69%, respectively.

Conclusion:

FP results of mpMRI were detected in more than half of our sample, more than one-third were presented in Pi-RAD3, improved imaging techniques to decrease FP rates are highly needed.
A conjecture of Zagier and the value distribution of quantum modular forms
Authors: Aistleitner Christoph , Borda Bence
Published: May 2024

In his influential paper on quantum modular forms, Zagier developed a conjectural framework describing the behavior of certain quantum knot invariants under the action of the modular group on their arguments. More precisely, when

J_{K,0}

denotes the colored Jones polynomial of a knot

K

, Zagier’s modularity conjecture describes the asymptotics of the quotient

J_{K,0}(e^{2 \pi i \gamma(x)}) / J_{K,0}(e^{2 \pi i x})

as

x \to \infty

along rationals with bounded denominators, where

\gamma \in \mathrm{SL}(2,\mathbb{Z})

. This problem is most accessible for the figure-eight knot

4_{1}

, where the colored Jones polynomial has a simple explicit expression in terms of the

q

-Pochhammer symbol. Zagier also conjectured that the function

h(x) = \log (J_{4_1,0}(e^{2 \pi i x}) / J_{4_1,0}(e^{2 \pi i /x}))

can be extended to a function on

\mathbb{R}

which is continuous at irrationals. In the present paper, we prove Zagier’s continuity conjecture for all irrationals for which the sequence of partial quotients in the continued fraction expansion is unbounded. In particular, the continuity conjecture holds almost everywhere on the real line. We also establish a smooth approximation of

h

, uniform over all rationals, in accordance with the modularity conjecture. As an application, we find the limit distribution (after a suitable centering and rescaling) of

\log J_{4_1,0}(e^{2 \pi i x})

, when

x

ranges over all reduced rationals in 

(0,1)

with denominator at most

N

, as

N \to \infty

, thereby confirming a conjecture of Bettin and Drappeau.
Clinical diagnostic advances in intestinal anastomotic techniques: Hand suturing, stapling, and compression devices
Authors: Lee Ah Young , Cho Joo Young
Published: May 2024

The development of intestinal anastomosis techniques, including hand suturing, stapling, and compression anastomoses, has been a significant advancement in surgical practice. These methods aim to prevent leakage and minimize tissue fibrosis, which can lead to stricture formation. The healing process involves various phases: hemostasis and inflammation, proliferation, and remodeling. Mechanical staplers and sutures can cause inflammation and fibrosis due to the release of profibrotic chemokines. Compression anastomosis devices, including those made of nickel-titanium alloy, offer a minimally invasive option for various surgical challenges and have shown safety and efficacy. However, despite advancements, anastomotic techniques are evaluated based on leakage risk, with complications being a primary concern. Newer devices like MAGNAMOSIS use magnetic rings for compression anastomosis, demonstrating greater strength and patency compared to stapling. Magnetic technology is also being explored for other medical treatments. While there are promising results, particularly in animal models, the real-world application in humans is limited, and further research is needed to assess their safety and practicality.
Exchange rate movement and stock returns in most capitalised economies in Sub-Saharan Africa
Authors: Ogunsanya Ibukun , Adamson Temitope Wasiu
Published: May 2024

In line with the extant literature that financial markets do mutually cooperate, this study investigates the nexus between exchange rate movement and stock returns in the six most capitalised economies in Sub-Saharan Africa (SSA). The study ascertains the relevance of the traditional or portfolio adjustment theory to sub-Saharan Africa’s financial markets. The study accounted for heterogeneity and dependence among the cross-sections and applied the Driscoll and Kraay and the Feasible Generalised Least Square econometric procedures on Bloomberg (2023) monthly datasets spanning between 2000:1 and 2022:12. The study findings reveal the nexus between the variables flows from stock returns to the exchange rate in SSA and some consistency with the argument of the portfolio adjustment theory. Estimates of Dumitrescu-Hurlin's (2012) Granger non-causal test also reveal a unidirectional causal relationship between both variables in the most capitalised economies in SSA. Macroeconomic policies that vitiate the limitations of both variables in SSA are recommended.
Prevalence and associated factors of family planning among students of health training institutes in Juba: A cross sectional descriptive study
Authors: Alier Kon , WApary Ezbon , Cham Akway , Tulba Rita , Garang Lueth , Malual Abdallah , Angok Tumalu , Ajuet Achol , Kuot Aldo , Akuei Donato
Published: May 2024

Introduction: Family planning (FP) is less prevalent in South Sudan yet information on the subject is scarce and varied from one source to another. This study assessed the prevalence and associated factors in family planning among students at health science training institutes in Juba City.
Method: This was a cross-sectional survey of students’ self-reported utilisation of FP methods. Four hundred randomly selected students from five health training institutes (HTIs) in Juba City participated. Data collection was done using a pretested structured questionnaire. IBM SPSS 23 software was used for data analysis. Chi squared tests and regression analyses were performed to determine the associated factors.
Results: Among the 400 participants, the lifetime prevalence of FP methods was 77.3%, of which modern contraceptive use was 22%. FP was more prevalent among participants aged 45-50 (85.7%) and females (80.7%). Eighty-seven percent of divorced couples and 91.3% of traditional believers reported practicing FP. More nursing/midwifery cadres within the professional category reported practicing FP, as well as 90.4% of rural respondents. Eighty-three percent of respondents working in pharmacies said they practice FP, compared to 68.1% of those working in clinics. FP practice was similar among participants who were aware (78.9%) and those who denied being aware (72.5%). Marital status (p < 0.001), religion (p < 0.001), residence (p < 0.001), and place of work (p = 0.037) were significantly associated with FP.
Conclusion: The prevalence of family planning among students at Health Training Institutes in Juba City is high compared to national estimates, but the contraceptive overall prevalence rate is still low. It is significantly associated with marital status, religion, residence, and place of work. There is a need to continue the effort.
Management of cerebral amyloid angiopathy and atrial fibrillation: We are still far from precision medicine
Authors: Fusco Liuba , Palamà Zefferino , Scarà Antonio , Borrelli Alessio , Robles Antonio Gianluca , De Masi De Luca Gabriele , Romano Silvio , Sciarra Luigi
Published: May 2024

The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy (CAA) and atrial fibrillation (AF). In fact, CAA is an age-related cerebral vasculopathy that predisposes patients to intracerebral hemorrhage. Nevertheless, many AF patients require oral systemic dose-adjusted warfarin, direct oral anticoagulants (such as factor Xa inhibitors) or direct thrombin inhibitors to control often associated with cardioembolic stroke risk. The prevalence of both CAA and AF is expected to rise, due to the aging of the population. This clinical dilemma is becoming increasingly common. In patients with coexisting AF and CAA, the risks/benefits profile of anticoagulant therapy must be assessed for each patient individually due to the lack of a clear-cut consensus with regard to its risks in scientific literature. This review aims to provide an overview of the management of patients with concomitant AF and CAA and proposes the implementation of a risk-based decision-making algorithm.