bluuebunny/crossref_metadata_2025 huggingface dataset:
A Surveillance Study of the Serotypes of Streptococci in the Throat and Skin Lesions in Acute Rheumatic Fever and Rheumatic Heart Disease Patients and their Families
Authors: Arumugam Praveen , Yadav Amit , Rawat Yogita
Published: February 2023

Objectives:

The objectives of this study were to determine the colonization of the throat and skin among patients of rheumatic heart disease (RHD) or acute rheumatic fever (ARF) and to elucidate the different Lancefield serotypes of streptococci (Group A, Group C, and Group G) among them.

Methods:

The prospective observational surveillance study was conducted from November 2016 to March 2018 among 161 enrolled family members belonging to 30 families with one of their patients being diagnosed with RHD/ARF. The outcome measures were period prevalence of serotypes of streptococci, streptococcal colonization of throat and skin lesions, and association of age and antibody titers with RHD/ARF.

Results:

Out of 30 families enrolled in our study, positive throat (n = 18)/skin (n = 1) cultures were found in 7 families (n = 19). The cultures were positive only for Group A streptococci (GAS), while none of the samples showed positivity for Group C or G serotypes. Overall period prevalence for our study period was 3.2%. Among the 18 members positive for GAS throat culture, 13 (72.2%) belonged to the age group <15 years (P < 0.025). The positive cultures in the throat sample were more in the ARF families than RHD families (P < 0.001). There was no association of culture positivity with antibody titer (P > 0.05).

Conclusion:

In conclusion, we found only GAS colonization in significantly higher proportion among the family members of cases of ARF in comparison to RHD. Rather there was no case of Group C and G streptococci colonization in cases or family members of RHD/ARF.
Melioidosis: Is it Still Underdiagnosed?
Authors: Kamath Vasantha , Priyanka M. , Reddy Deepthi
Published: February 2023

Burkholderia pseudomallei, a Gram-negative bacterium, is the cause of Melioidosis, a disease that is known to cause significant morbidity and mortality in Southeast Asia. It is also classified as a potential biological warfare agent and is considered a category B priority pathogen. Despite being common in these areas, melioidosis is often underdiagnosed due to lack of awareness of its clinical and microbiological characteristics, limited health-care resources, and the varied ways in which it can present. It is important to recognize the clinical features of melioidosis early on and properly manage the disease to reduce its impact.
Role of Polymerase Chain Reaction in Peritoneal Dialysis Patients with Nonbacterial Peritonitis
Authors: Srivastava Atul Kumar , Ghosh Indranil , Dubey Sudhir , Sonawane Shrikant
Published: February 2023

Introduction:

Culture-positive peritoneal dialysis (PD)-related peritonitis depends on proper sample collection and culture technique. Patients are investigated for fungal and tubercular peritonitis once the initial peritoneal effluent grows no bacteria and the patient is unresponsive to antimicrobials. However, they are diagnosed late in the course of illness and lead to irreversible peritoneal damage preventing reinsertion of PD catheter. The aim of the study was to assess the role of polymerase chain reaction (PCR) in diagnosis of fungal and Mycobacterium tuberculosis (MTB)-related peritonitis in patients on PD who presented with features of peritonitis.

Materials and Methods:

This was a prospective study and included patients who were diagnosed to have PD-related peritonitis as per the International Society of PD guidelines. All patients underwent panfungal and MTB complex (MTC) PCR of PD effluent on day 1 of admission.

Results:

Eighty-five patients with PD-related peritonitis were included in the study. In patients with no bacterial growth on PD fluid, panfungal PCR was positive in 22 (25.8%) patients and 2 (2.4%) patients had positive MTC PCR. Fungal organism could be isolated in 10 (11.7%) patients. Nine percent of patients with fungal peritonitis died.

Conclusion:

The use of PCR in patients with PD-related peritonitis will help in early diagnosis and management of fungal and tubercular peritonitis. It will also help in reducing mortality in these patients.
Cutaneous Manifestations of Systemic Lupus Erythematosus: A Descriptive Study from a Tertiary Care Center in Southern India
Authors: Ashwini N. , Jayashankar C. A. , Pinnelli Venkata Bharat Kumar , Prakash Bhanu , Gundreddy Honika , Shalini A. S.
Published: February 2023

Background:

Systemic lupus erythematosus (SLE) is a complex autoimmune disease that affects multiple systems in the body, including the skin. It is more common in women and usually occurs in the fourth decade of life. The skin is the second most frequently affected organ in SLE, occurring in about 80% of patients.

Aim:

The purpose of this study was to analyze the clinical and epidemiological characteristics of SLE and evaluate the different patterns of cutaneous involvement in SLE patients.

Materials and Methods:

Sixty newly diagnosed SLE patients (17 male, 43 female) aged 9–58 years were included in the study.

Results:

Malar rash was observed in 44 (73.3%) patients, discoid rash in 17 (28.3%) patients, photosensitivity in 38 (63.3%) patients, and oral ulcers in 30 (50%) patients. All these skin lesions were associated with underlying systemic involvement.

Conclusion:

Our study found that active cutaneous manifestations of SLE were strongly correlated with systemic involvement.
Parental Perspectives Regarding Circumcision during the Coronavirus Disease 2019 Pandemic in Indonesia
Authors: Kurniawan Jemmy , Daryanto Besut , Nurhadi Pradana , Kustono Andri
Published: February 2023

Background:

Coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and affected the healthcare system, including the deferral of surgical practice. There are various reactions regarding delayed surgeries, but parental viewpoints towards circumcision remain scarce.

Aims and Objectives:

In light of the pandemic, this study aimed to evaluate how parents feel about circumcision and the probable determining variables.

Materials and Methods:

This study is a cross-sectional study based on an online questionnaire available from March to April 2022. The factors affecting the decision were analysed using logistic regression.

Results:

Of 1,218 (26.28%) parents who completed the survey, 879 (18.96%) met the inclusion criteria and were included in this study. Among them, 615 (70.00%) parents agreed to delay circumcision during the COVID-19 pandemic. These respondents were more likely to be non-Muslim (P = 0.01), have no relatives whose work is related to medicine or paramedicine (P = 0.02) and have monthly income equal to or below the regional minimum wage (P = 0.03). After adjusting the potential confounder, non-Muslim religion (odds ratios, 2.87; 95% confidence interval, 1.27–6.49; P = 0.012) was found to be the only independent predictor for agreeing to the deferral of circumcision amid the pandemic.

Conclusion:

Most parents agreed to postpone circumcision due to the fear of COVID-19 exposure. In order to help them feel less apprehensive about this matter, it is important to educate them about the medical benefits of circumcision and the safety of this procedure.
Lung Hydatid and Broncho-Cavitary Communications
Authors: Sharma Nitin , Sharma Shipra , Memon M. Amin , Sharma Mini
Published: February 2023

Aims:

The aim was to analyse the challenges and outcomes in operated patients of hydatid lung with broncho-cavitary communications.

Materials and Methods:

The retrospective data between June 2017 and May 2022 were obtained. The number of broncho-cavitary communications was recorded and they were suture repaired using polypropylene. The duration required for repair and the average fall in the SpO2 were recorded. Those with incomplete data or follow-up were excluded. The outcome parameters considered were number of broncho-cavitary communications, duration of stay, duration of intercostal tube, duration of air leak and requirement of ventilator support.

Results:

A total of 33 patients out of 36 formed the study group. The mean age was 6 years (range 2–18 years). There were 23 right-sided, eight left-sided and two bilateral cysts. Broncho-cavitary communications were seen in 33 patients. The average number of communications was 3 (range: 2–8). The average duration required to suture close the communications was 30 s (range 20–180 s). The average fall in the SpO2 was 40% (range 20%–74%). The main challenge was rapid identification of communications and prompt repair. The mean duration of surgery was 2.15 h (range 1.45–3.15 h). Ventilator support in the post-operative period was required in four patients. The average duration of intercostal tube drainage required was 7 days (range: 6–14 days). The average duration of hospital stay was 14 days (range 12–34 days). All the communications were repaired using Prolene 3-0 sutures. None of the patients was operated with a double-lumen endobronchial tube.

Conclusion:

Broncho-cavitary communication in hydatid cyst is associated with an operative challenge due to sudden air leak. These patients require judicious management.
A Prospective Epidemiological Survey of Paediatric Trauma in Africa
Authors: Ali Abdelbasit Elsayed , Ademuyiwa Adesoji O , Lakhoo Kokila , Kefas John , Houmenou Esperance , Abdulsalam Moruf , Leopold Azakpa , Bankole Rouma , Gbenou Seraphin , Covi Pautin
Published: February 2023

Background:

Trauma is a leading cause of morbidity and mortality in children worldwide. There is a need for development and provision of efficient paediatric trauma services based on adequate information and funding which are lacking in low- and middle-income countries.

Aims:

This study was carried out to assess the scale of the problem, identify the most common causes of trauma in Pan African Paediatric Surgical Association (PAPSA) zone and to define the limiting factors for provision of the necessary services required to reduce the potential mortality and disability.

Materials and Methods:

Data were collected through an electronic form sent out in PAPSA platform. Members were requested to provide prospective data on all paediatric major trauma admitted to or seen at their health facilities between the beginning of April 2019 and the end of June 2020. Hospital location, child’s age, gender, type of injury, mechanism of injury, severity, initial management, method of transport, time to arrive to hospital, availability of surgical specialities, length of hospital stay and injury outcome were analysed.

Results:

There were 531 entries. The mean age was 3.53 years and median age 1.34 years. Male-to-female ratio was 2:1. The leading causes for injuries were falls 194 (36.53%) and motor vehicle crashes (MVCs) 176 (33.15%) followed by obstetrical 42 (7.9%), thermal 27 (5.1%) and domestic injuries 22 (4.1%). The most common injuries were limb fractures 181 (34.1%) and traumatic brain injury 111 (20.9%). Public and private transport were used in 313 (58.9%), while ambulance service was used in only 54 (10.1%). Distances to a health facility varied between 1 and 157 km. 70.2% of cases did not receive any primary care, while definitive care was received in 95.5% of the cases. Outcome was full recovery in 90.6% of patients, morbidity in 8.1% and a mortality rate of 1.3%.

Conclusions:

Most of the injuries were in the under 5-year age group. The two main causes of trauma in children in this study were the falls from height and MVCs. Long distance travels to reach health-care facilities were noticeable in this study, together with substantial lack of adequate ambulance facilities and shortage in necessary subspecialty services such as neurosurgical, orthopaedics and rehabilitation. Implementing proposed recommendations can reduce the burden.
Outcome of Transanal Endorectal Pull-Through in Patients with Hirschsprung’s Disease
Authors: Sholadoye Tunde Talib , Ogunsua Oluseyi Oyebode , Alfa Yakubu , Mshelbwala Philip Mari , Ameh Emmanuel Adoyi
Published: February 2023

Background:

Transanal endorectal pull-through (TERPT) has become one of the preferred treatments for Hirschsprung’s disease (HD) in our setting. This report aims to evaluate the current outcome of TERPT in the setting.

Materials and Methods:

A retrospective review of 71 children who had TERPT for histologically-confirmed HD in 11 years (2006–2017) in Nigeria.

Results:

There were 48 boys and 23 girls; aged 3 days–12 years at initial presentation (median = 10 months). Three (4.2%) patients had associated anomalies (duodenal atresia; anorectal malformation and sensorineural deafness with hypopigmented skin patches each). Age at TERPT was 2 months to 15 years (median = 3 years), with surgery waiting time of 1 month-14.9 years (median = 18 months). Sixty-six (93.0%) patients had rectosigmoid, four (5.6%) patients had long segment and one (1.4%) had total colonic disease. Five (7.0%) patients with large megacolon and one (1.4%) with the total colonic disease had assisted abdominal resection of the colon at TERPT. Seventeen (23.9%) patients had post-operative complications, including post-operative enterocolitis 8 (11.3%); anastomotic dehiscence 3 (4.2%); retained aganglionic segment 2 (2.8%); anastomotic stenosis 2 (2.8%), resulting in prolonged hospital stay (P = 0.0001; range = 1–30 days; median = 5 days). The mortality rate was 4.2% (3) from malignant hyperthermia in one patient and in 2 patients, the cause of mortality was unclear. Patients were followed up for 3–6 years (median = 3.5 years). Bowel movement stabilised to 2–4 times daily by 6 weeks after surgery.

Conclusion:

TERPT is a safe treatment for HD in this setting with good short-term outcomes. Longer follow-up is necessary to further evaluate the long-term bowel movement outcomes.
Role of computed tomography angiography in deep inferior epigastric perforator flap breast reconstruction surgery: A retrospective observational study
Authors: Mahajan Abhishek , Jain Kalpesh , Agarwal Ujjwal , Gupta Himanshu , Agarwal Rajat , Jaiswal1 Dushyant , Shankhdhar Vinay , Mantri Mayur , Popat Palak , Mathews Saumya , Yadav Prabha
Published: February 2023

Background:

Deep inferior epigastric perforator (DIEP) flap is a technique used for breast reconstruction where the skin and subcutaneous tissues of the abdominal wall are transferred to the chest wall post-mastectomy. Computed tomography (CT) angiography localizes perforators along the anterior abdominal wall.

Objectives:

We conducted a retrospective study with the primary objective of evaluating the role of CT angiography in identifying the ideal perforator for the DIEP flap reconstruction and concordance between the radiologically identified perforator and the perforator preferred by the surgeons.

Materials and Methods:

Between July 1, 2015 and September 15, 2019, we included 106 patients in this retrospective study conducted in the Departments of Radiodiagnosis, and Plastic and Reconstructive Surgery at the Tata Memorial Hospital in Mumbai, India. These patients had a CT scan of the deep inferior epigastric artery perforator performed prior to reconstructive breast surgery with DIEP flap. Patients who underwent DIEP flap reconstruction surgery without prior imaging, breast reconstruction other than DIEP flap, and those with a history of abdominal surgeries like abdominoplasty or colostomy were excluded. Two radiologists blinded to the surgical details analyzed the pre-operative CT images to identify the ideal DIEP perforator. Radiological findings were compared with the surgical outcomes and complications.

Results:

The mean age of the patients was 36.7 years (interquartile range, 31.6-41.8). The most common type of the deep inferior epigastric artery in our population was type 2 (deep inferior epigastric artery dividing into two intramuscular branches) on either side. Concordance between the perforator identified on imaging and that selected by the surgeons was 80%. The selection of the larger caliber right sided perforator showed decrease in the recipient site complications; P=0.002.

Conclusion:

The strong correlation between the perforator selected by the surgeons and the one seen on imaging highlights the importance of imaging before the surgery in improving surgical planning and clinical outcomes. A dedicated protocol based on CT angiogram for DIEP is imperative in order to locate the best perforator which can be correlated intraoperatively and be considered the ideal perforator.
Clinicopathological analysis of ischemia/reperfusion time-zero injury biopsies and its role in early allograft dysfunction in hepatic transplantation (retrospective cross-sectional study)
Authors: Abd Elmaogod Eman A. , Hegazy Azza , Mahmoud Abla S. , Marwan Ibrahim , Hegazy Osama , El-Abgeegy Mohamed , Elsergany Heba F. , Mahmoud Eman I. El-Desoki , Mohamed Amal A. , Soliman Hossam E.M. , Seleem Mohamed I. , Gerges Shawkat S. , Albotaly Ahmed , Hamdy Ahmed , Abdelaziz Heba , Abdelraouf Amr
Published: February 2023

Background and objectives

Orthotropic liver transplantation is the only choice for treatment of end-stage liver diseases. B cell lymphoma 2 (BCL2) is a protein that regulates apoptosis. We aim to pinpoint the role of time-zero biopsies in predicting early graft dysfunction following liver transplantation by evaluation of BCL2 expression in hepatocyte.

Patients and methods

Thirty seven liver biopsies were evaluated histopathologically for ischemia–reperfusion injury and immunohistochemically by expression of BCL2.

Results

Out of 37 cases studied, 33 (89.2%) males and four (10.8%) females with a mean±SD age of 46.48 ± 12.05 years old. Their alanine aminotransferase average was 137.56 ± 76.46 U/l, the aspartate aminotransferase average was 62.84 ± 58.26 U/l, while international normalized ratio average was 1.79 ± 0.59. Histopathology shown, ballooning degeneration in 28 (75.7%), apoptosis was negative in 12 (32.4%), few in 13 (35.1%), and many in 12 (32.4%). Immunostaining with anti-BCL2 antibodies for apoptotic hepatocytes was negative in 12 (32.4%) and positive in 25 (67.6%). BCL2 expression was significantly higher with ballooning degeneration (P=0.019). BCL2 expression was significantly higher with apoptosis (P<0.001). Alanine aminotransferase, aspartate aminotransferase, and bilirubin levels were significantly higher with positive BCL2 expression (P=0.002, 0.025, and 0.002, respectively) and with positive ischemia/reperfusion injury (moderate or severe changes) (P=0.005, 0.032, and 0.008, respectively).

Conclusion

Liver pathology biopsy remains the ‘gold standard’ for the diagnosis of allograft dysfunction as when the clinical picture, liver enzymes, and imaging parameters are unclear.
Evaluation of sex-determining region Y box 6 and heart development protein with EGF-like domain 1 in differentiating epithelioid mesothelioma from lung adenocarcinoma
Authors: Abd Allah Marwa S. , Mohamed Samy A. , Said Eman M.
Published: February 2023

Background

Malignant mesothelioma can be difficult to be distinguished from lung adenocarcinoma without immunohistochemistry. However, conventional mesothelial markers until now do not have optimal sensitivity and specificity, necessitating the identification of new markers.

Patients and methods

Sex-determining region Y box 6 (SOX6) and heart development protein with EGF-like domain 1 (HEG1) were evaluated by immunohistochemistry in 55 cases of epithelioid mesothelioma and 50 cases of lung adenocarcinoma. All cases were previously immunostained by calretinin and D2-40. Both sensitivity and specificity for distinguishing epithelioid mesothelioma from adenocarcinoma were calculated.

Results

SOX6 expression was present in 54 (98%) of 55 cases of epithelioid mesothelioma, compared with its expression in only four (8%) of 50 cases of lung adenocarcinoma. The sensitivity and specificity of SOX6 expression for differentiating epithelioid mesothelioma from lung adenocarcinoma were 98.2 and 92.0%, respectively. HEG1 expression was present in 52 (94.5%) of 55 cases of epithelioid mesothelioma, compared with its complete negative expression in all studied cases of lung adenocarcinoma. The sensitivity and specificity of HEG1 for differentiation epithelioid mesothelioma from lung adenocarcinoma were 94.5 and 100%, respectively. The sensitivity and specificity of both SOX6 and HEG1 were higher than those of calretinin and D2-40.

Conclusion

SOX6 and HEG1 may be used as immunohistochemical markers for differentiating epithelioid mesothelioma from lung adenocarcinoma.
Evaluation of the significance of human class I homeobox A13 and STK4/MST1 expression in conventional colorectal adenoma and adenocarcinoma and correlation with clinicopathological parameters (immunohistochemical study)
Authors: Abdel-Aal Ebtehal M. , Soliman Amira El-Sayed
Published: February 2023

Background

Colorectal carcinoma (CRC) is the third most common cancer in the world. Human class I homeobox A13 (HOXA13) was initially identified as a transcription factor and has an important role in embryonic development and malignant transformation. Mammalian STE20-like kinase 1 (STK4/MST1) encodes a serine/threonine kinase that is the mammalian homolog of the Hippo pathway and plays an important role in controlling cell growth, apoptosis, and organ size.

Aim

This work aimed to evaluate the role of HOXA13 and STK4/MST1 in conventional colorectal adenoma and adenocarcinoma.

Materials and methods

This retrospective study was carried out on 20 cases of conventional colorectal adenoma and 30 cases of conventional colorectal adenocarcinoma. HOXA13 and STK4/MST1 immunostaining was done and assessed for each case. Correlation with the clinicopathological findings and statistical analysis was studied.

Results

In the carcinoma cases, there was a highly significant direct statistical correlation between HOXA13 expression and tumor grade, lymph node metastasis, and TNM stage (P<0.01 for each). Inverse statistical correlation between STK4/MST1 expression and tumor grade, depth of tumor invasion (T), and TNM stage (P<0.01 for each) was found. HOXA13 and STK4/MST1 immunoexpression showed direct highly significant relation with the transition from adenoma to adenoma with dysplasia to adenocarcinoma (P<0.01). There was a highly significant inverse statistical correlation between HOXA13 and STK4/MST1 expression in the studied cases of CRC (P<0.01). According to receiver-operating characteristic curve, both markers were good in the prediction of metastatic potential in the carcinoma cases using the TNM stage as a parameter with a sensitivity of 85%.

Conclusion

HOXA13 was immunohistochemically overexpressed, while STK4/MST1 was downexpressed in progression from colorectal adenoma to adenoma with dysplasia to adenocarcinoma cases. HOXA13 and STK4/MST1 might have a potential role as independent prognostic factors in CRC and may have validity to predict metastatic potential of CRC.
Sirtuin 6 expression in colorectal adenocarcinoma
Authors: Abdelhafez Dalia N. , El Nemr Reham S. , Mouhammed Heba H.M.
Published: February 2023

Background

Sirtuin 6 (SIRT6), a NAD+-dependent deacetylase SIRT6 has been demonstrated to inhibit tumor development in a variety of cancers. Colorectal carcinoma is a difficult malignancy with high morbidity and mortality rates. However, it is unknown if SIRT6 has a direct role in colon carcinogenesis or what the underlying mechanism is.

Aim and objectives

The aim of this work was to study the expression of SIRT6 in colorectal carcinoma and its correlation with other pathological prognostic factors to clarify the role of SIRT6 in colorectal cancer (CRC) and determine whether SIRT6 could be a potential new prognostic biomarker for patients with CRC.

Patients and methods

We studied the tissues of 40 CRC patients to see whether SIRT6 has a role in colon cancer. Tumor tissue sections have been stained with hematoxylin and eosin and immunostained for SIRT6.

Results

The clinicopathological features of all cases were studied and statistical correlations between SIRT6 expression and clinicopathological parameters were done showing significant relations between SIRT6 expression and both tumor size and distant metastases with P values equal to 0.042 and 0.016, respectively.

Conclusion

SIRT6 is thought to play a significant role in the tumorogenesis of cancer colon; larger studies of all cancer colon variants are recommended for further declaration of each role.
Impact of erector spinae plane block on the quality of recovery after lumbar spine decompression surgery: A comparative study between addicts and non-addicts
Authors: Amin Samar R. , Abdelfatah Fatma A.
Published: February 2023

Background and Aims:

Acute pain management in drug addicts is a critical yet understudied topic. Drug addicts have a decreased pain threshold, impairing anaesthetic pain control. This study aimed to evaluate the postoperative quality of recovery in addicts and non-addicts after receiving erector spinae plane block (ESPB) with general anaesthesia.

Methods:

Sixty males, aged 18-60 years, with an American Society of Anesthesiologists physical status I/II, scheduled for elective lumbar decompression surgery, were divided into two equal groups. Group A included 30 addicts and group N included 30 non-addicts. Both groups received bilateral ultrasound-guided ESPB with 20 mL bupivacaine (0.25%) before induction of general anaesthesia. The primary outcome was comparison of the 24-hour postoperative quality of recovery (QoR-15) score. The secondary outcomes were time to first analgesic requirement, postoperative pain scores, morphine consumption, and adverse events.

Results:

The QoR-15 score was higher in group N (median = 128.5, interquartile range = 107-136) than in group A (118 [99-130]), indicating a better recovery in group N. The visual analogue scale pain score was lower in group N than in group A, especially in the first 12 hours postoperatively. Time to first analgesic request was significantly longer in group N than in group A (mean ± standard deviation: 8.67 ± 2.74 and 5.53 ± 1.64 hours, respectively, P =0.001), Morphine consumption was significantly higher in group A than in group N (9.62 ± 3.2 and 7.08 ± 2.57 mg, respectively, P =0.041).

Conclusion:

Drug addicts experienced decreased analgesic efficacy of ESPB compared to non-addicts, with comparable postoperative QoR-15 score following lumbar decompression surgery.
Quadratus lumborum block vs. transversus abdominis plane block in laparoscopic trans-abdominal pre-peritoneal repair of inguinal hernia in adults: A randomised controlled trial
Authors: Roy Avishek , Bhoi Debesh , Chhabra Anjolie , Mohan Virender K. , Darlong Vanlalnghaka , Prasad Ganga
Published: February 2023

Background and Aims:

Laparoscopic trans abdominal preperitoneal (TAPP) repair of hernia is one of the most commonly performed surgeries and may cause significant postoperative pain. Among different truncal block techniques, quadratus lumborum (QL) and transversus abdominis plane blocks (TAP) are used during this abdominal surgery. We aimed to investigate whether, bilateral QL block by trans-muscular approach provided better analgesia as compared to posterior TAP block in these patients.

Methods:

Forty adult patients with American Society of Anesthesiologists physical status I and II, undergoing inguinal hernia repair were randomized to receive either QL or TAP block, with 20 mL of 0.25% ropivacaine bilaterally. The primary objective of the study was to compare the total fentanyl consumption (in μg) within 24 hours postoperatively. The secondary objectives studied were dermatomal spread, quality of recovery at discharge and at 3 months postoperatively.

Results:

There was a significant reduction in total 24-hour fentanyl consumption (552 ± 229.56 vs 735.5 ± 264 μg, P =0.01) in the QL group, with longer duration of analgesia [282.5 ± 89.9 min group TAP vs. 354.8 ± 107 min QL, (mean difference -72.34,95% confidence interval -135.516 to -9.024), P =0.03], as compared to TAP group. At T8 and T9 dermatomes, greater proportion of patients in the QL group attained analgesia. Quality of Recovery at 24 hours and at 3 months of follow-up were comparable.

Conclusion:

QL block provided better perioperative analgesia than TAP block, in patients undergoing laparoscopic hernia repair. It also leads to greater dermatomal spread but without any decrease in the incidence of chronic pain at 3 months postoperatively.
Correlation of transcranial Doppler based parameters with computed tomography assessed cerebral oedema score in patients with traumatic brain injury: A prospective observational study
Authors: Ammar Mona A , Abdelmoneim Wael , Abdalla Waleed
Published: February 2023

Background and Aims:

Cerebral oedema and increased intracranial pressure are associated with poor neurological outcomes in traumatic brain injury (TBI). This study aimed to examine the correlation between transcranial doppler (TCD) derived indices and computed tomography assessed cerebral oedema score in patients with TBI.

Methods:

This prospective observational study was conducted between April 2021 and December 2021 after approval from the University Research Ethics Committee (R75/2021) and registration with the clinicaltrials.gov (NCT04834453). Cerebral oedema on computed tomography (CT) imaging of the brain was scored as (0 = no cerebral oedema, 1 = mild cerebral oedema, 2 = moderate cerebral oedema, and 3 = severe cerebral oedema). The daily neurological assessment was performed using Glasgow coma scale score. TCD-based parameters, mean flow velocity (MFV), and pulsatility index (PI) in middle cerebral arteries were simultaneously obtained.

Results:

There was a significant negative correlation between MFV and cerebral oedema score (r = - 0.840, P <.001) and a significant positive correlation between PI and cerebral oedema score (r = 0.825, P <.001) on the seventh day of assessment. Significant differences were noted in MFV [53.17 ± 7.52 cm/s vs. 34.55 ± 3.35 cm/s] and PI [1.02 ± 0.16 vs. 1.46 ± 0.07] in patients with improvement and no improvement in cerebral oedema after seven days of TBI management.

Conclusion:

Bedside assessments of TCD-based parameters of MFV and PI correlate well with CT-based assessment of cerebral oedema in patients with TBI.
Evaluation of efficacy and safety of a single dose Tranexamic acid in reducing blood loss during colorectal cancer surgery. A randomised, placebo controlled, double-blinded study
Authors: Shaker Ehab H , Fayek Ehab S , Elrawas Mai M
Published: February 2023

Background and Aims:

Colorectal cancer surgeries are commonly performed nowadays. They are considered as extensive procedures requiring perioperative blood transfusion in 32% to 68% of cases. The objective of this study was to evaluate the anti-haemorrhagic effects and safety of a single dose of tranexamic acid in such surgeries.

Methods:

Sixty patients scheduled for colorectal cancer surgeries were randomly assigned (TA) into two equal groups. Group TA received 10 mg/kg tranexamic acid in 100 ml of 0.9% NaCl immediately following induction of anaesthesia and control group received 100 ml 0.9% NaCl. The primary outcome was total blood loss reduction. The secondary outcomes were total number of patients requiring blood transfusion and occurrence of any thromboembolic events within 30 days after surgery.

Results:

Intraoperative and total blood loss were lower in TA group compared to the control group (P = 0.010, 0.003, respectively) while postoperative blood loss was comparable between both groups. The need for blood transfusion was lower in TA group (P = 0.038). Number of blood units transfused was also lower in TA group. Mean arterial blood pressure, serum creatinine and urine output in first 24 h postoperatively were comparable between both groups. Haemoglobin level in the first postoperative day was higher in TA group (P = 0.002), but was comparable between the groups at 2 weeks preoperative and from second up to fifth day postoperatively.

Conclusion:

A single dose of TA administered between induction and start of surgical procedure may reduce total blood loss and need of transfusion in colorectal cancer surgeries without any serious adverse effects.
A comparative study of 10% lidocaine spray versus eutectic mixture of 2.5% lidocaine and 2.5% prilocaine (EMLA) to attenuate pain of peripheral venous cannulation in children: A prospective randomized control trial at a tertiary care centre
Authors: Kulkarni Malavika M. , Patil Anirudh T. , Sinha Shweta
Published: February 2023

Background and Aims:

Eutectic mixture of local anesthetics (EMLA) (2.5% lidocaine and 2.5% prilocaine) cream is the commonly used topical anesthetic for painful intradermal procedures. Topical 10% lidocaine spray has successfully been used to anesthetize mucosal surfaces. Owing to its skin penetrative properties, this study was conducted to compare dermal analgesia between 10% lidocaine spray and EMLA cream for intravenous (IV) cannulation in children.

Methods:

In this prospective single-blind randomized study, ninety-nine Paediatric patients were assigned into Group A (number(n) =51) with Lignocaine 10% spray applied 10 minutes and Group B (n = 48) EMLA cream applied 1 hour prior to cannulation. Vital signs were recorded before, during, and after the procedure. The primary objective of the study was assessment of severity of pain during IV cannulation using 10 cm visual analogue scale (VAS). Secondary objectives such as ease of cannulation and adverse effects were also noted.

Results:

All cannulations were performed in the first attempt with no adverse effects in both lidocaine group and EMLA group. The median (interquartile range) VAS score was 2 cm (1 to 3) in both the groups with a P value of 0.58.

Conclusion:

Topical 10% lidocaine spray applied ten minutes before venous cannulation is as effective as EMLA cream applied an hour before cannulation in children in providing dermal analgesia for intravenous cannulation with an added advantage of rapid onset of action in the former group.
Complications of Growing Rod Technique for Early Onset Scoliosis
Authors: Srivastava Abhishek , Gupta Anuj , Hanasoge Vikas , Jayaswal Arvind
Published: February 2023

Early onset scoliosis (EOS) is defined as scoliosis occurring in children less than 10 years of age. The EOS is a separate entity of discussion as development of lungs is restricted due to restricted growth of the chest wall, unlike in adolescent scoliosis which is more of a cosmetic problem. Therefore, in EOS, control of deformity at early stage and growth of the spine should go hand-in-hand. The most favored option in recent era is growing rods which allow growth of the spine but in a controlled manner. However due to fusionless nature, these techniques have high rate of complications. The complications primarily include implant related, wound related, and anesthetic complications. Recently impact of multiple surgeries on psychology of developing child has been reported. This narrative reviews the literature about complications associated with growing rod surgeries in EOS.
Challenges and opportunities in the implementation of competency-based medical education – A cross-sectional survey among medical faculty in India
Authors: Gopalakrishnan Shivkumar , Catherine A. Precilla , Kandasamy Sangeetha , Ganesan Harissh
Published: February 2023

BACKGROUND:

In India, competency-based medical education (CBME) is gaining foothold to transform the medical student into a doctor fulfilling community and societal needs. With that end in view the teaching faculty are getting sensitized and trained by the National Faculty Development Program (FDP). We aimed to assess the awareness about FDP among teaching faculty in medical colleges and study the attitude and perceived barriers to implementation of CBME.

METHODOLOGY:

A cross-sectional, electronically distributed, questionnaire-based study was conducted among medical faculty in India. The questionnaire identified participants’ awareness, attitude, and perceived barriers to CBME. Descriptive analysis was employed for continuous variables and internal comparison employing Chi-square test with α <0.05 for statistical significance.

RESULTS:

Among 251 participants 90.2% faculties from private institutes had undergone FDP as against 71% from Government sector (P = 0.008). We observed that 92.4% were aware, 80.2% had undergone Curriculum Implementation Support Program and 95.2% did agree that CBME will improve the medical education system. Major challenges perceived were high student to faculty ratio (67.7%), ill developed infrastructure (41.4%) and difficulties in assessment (41.1%). The popular solutions suggested were to increase faculty strength (73.7%), improve infrastructure (69.3%), extra remuneration (35.9%) and increase administrative support (30.7%). There was significant difference of opinions between teaching faculty of government and private sector (P = 0.017).

CONCLUSION:

Most of the medical faculty are aware of the need and have acquired a positive attitude towards enforcement of CBME. However, significant barriers do exist in the form of manpower and resources which need to be addressed.
A review on attraction factors of science and technology parks to firms in health sector
Authors: Mohammadzadeh Abbas , Javanmard Shaghayegh Haghjooy
Published: February 2023

BACKGROUND:

Over the past few years, a rapidly growing number of science and technology parks (STPs) in health sector have emerged across the world. There has been little discussion in the literature to show how STPs could make an attractive environment to absorb and retain potential firms. This is even more challenging for specialized STPs in health sector. The aim of this study is to identify the attractive factors for firms in a STP in health sector.

MATERIALS AND METHODS:

A scoping review method was undertaken to review the literature on seven databases (ScienceDirect, Scopus, ProQuest, Google Scholar, EconPapers, PubMed, and ISI Web of Science) for peer-reviewed articles published until 2019. The search results were screened against the inclusion of criteria to ensure they met the objectives. The eligible papers were then assessed on the basis of the full text, and finally the results were extracted.

RESULTS:

The attractive factors for firms and talents in multidimensional STPs and those in health sector are extracted and summarized. The attractive factors of multidimensional STPs, which includes health sector firms, and those specialized in health sector are summarized in three main categories; factors created by government and universities, and factors related to STP policies and those expected by the firms.

CONCLUSION:

To make STPs attractive for firms in health sector, there is a list of factors that are required to be done not only by STP itself, but also by the national and local government and industries. It is important to consider the factors that are expected by the firms to be implemented. The results of this study suggest that making STPs attractive for health sector firms needs close collaboration between government, universities, related industries, and STPs all together.
Quality of life and empowerment among women
Authors: Kundu Purnima , George Linu Sara , Yesodharan Renjulal
Published: February 2023

BACKGROUND:

Few women in history were respected by society because of their contributions to the field of science, arts, politics, and so on, but in general, women are deprived of their rights and being refrained from decision-making in major areas of individual and family life. This research tried to investigate the degree of empowerment and quality of life (QOL) of the women to find out the relationship between empowerment and QOL of women.

MATERIALS AND METHODS:

An exploratory survey was carried out among 210 purposively selected married women aged between 20 and 49 years in a selected municipality area of West Bengal. Data were obtained by one-to-one interviews using Women Empowerment Interview Schedule and WHOQOL Scale BREF.

RESULTS:

The mean total QOL score of the women was found as 98.59 ± 13.61. The transformed scores in the physical, psychological, social relation, and environmental domains were 74.92 ± 14.97, 66.58 ± 15.78, 81.00 ± 18.07, and 65.28 ± 17.99, respectively. The degree of empowerment was calculated as 64.71 ± 6.79. Among the women, 5% had poor, 62% had medium, and 33% had a high degree of empowerment. A weak positive correlation (r = 0.325, P = 0.001) was found between QOL and empowerment. Significant associations were established between empowerment and education (Fisher's exact = 13.975 [0.007]) and education gap with husband (Fisher's Exact = 8.68, P 0.069). Multiple regression analysis between empowerment dimensions and QOL shows that personal or family dimensions, including health, are a significant predictor for the QOL (P < 0.01).

CONCLUSION:

Most of the women had medium degree of empowerment. Increased degree of empowerment improves their QOL of women. Women should be aware of their rights that can enhance the empowerment in different dimensions of life.
Complementary and alternative medicine use in infertility
Authors: Sharifi Farangis , Roudsari Robab Latifnejad
Published: February 2023

The use of complementary and alternative medicine (CAM) is common in infertile women in different countries. The purpose of the current study was to review the infertile women's needs in relation to CAM use. This narrative review was conducted through searching English databases including Scopus, PubMed, Embase, Web of Science, Cochrane library as well as Persian databases consisted of SID, and Magiran. The used keywords included “CAM/therapy, needs, and Infertility.” All studies published in English peer-reviewed journals from conception to October 2020, which examined the infertile women's needs in the field of CAM use were included in the review. In the process of data extraction, two researchers screened the title, abstract, and full text of the articles. Out of the 2166 articles reviewed, 29 articles including six qualitative and mixed methods studies, four review, and 19 quantitative studies met the inclusion criteria. The results showed that infertile women have different needs in six domains consisted of educational and informational needs, the need for psychological counseling, supportive needs, the need for CAM use counseling, the need to treatment consistent with women's culture and demands, and the need to the integration of CAM with conventional medicine. Awareness of infertile women's needs toward CAM use can help health policymakers and planners in designing and implementing counseling services in accordance with the demands and culture of infertile couples. It also helps to develop a coherent program to integrate the use of CAM in the classical infertility treatment.
Exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit
Authors: Najafi Marzieh , Mohammadzadeh Hakimeh , Heydarian Nasrin , Rostami Mohammad , Ebadi Fard Azar Tooba , Mahmoodi Fatemeh , Chaboksavar Fakhreddin , Garmaroudi Gholamreza
Published: February 2023

BACKGROUND:

Satisfaction of patients is among the top priorities of health-care providers. Meeting with families is essential for patients who are admitted to various wards, although it has been restricted for many reasons such as its impact on physiologic indicators. This present research study aimed to exploring the influence of scheduled meetings on physiological indicators of hospitalized patients satisfaction facing acute myocardial infarction in the intensive care unit.

MATERIALS AND METHODS:

This study was a nonrandomized clinical trial with a control group conducted in the cardiac care unit ward of Hamadan's Ekbatan Hospital. Sixty patients with acute myocardial infarction were chosen through convenient sampling and assigned to intervention (planned meeting) and control (routine meeting) groups in a nonrandomized manner. Data were collected by a researcher-made questionnaire of patient satisfaction and the observatory checklist of physiologic indicators and then analyzed in IBM SPSS Statistics v23.

RESULTS:

The total mean score of satisfaction did not significantly differ between the two groups (P = 0.921). The satisfaction of patients for “the conduct of visitors” was significantly higher in the intervention group (P = 0.005). During the study, no meaningful difference was found between the two groups for physiologic indicators (P > 0.05), while these indicators, except for blood O2 saturation, were meaningfully increased in the control group during routine meetings (P < 0.05).

CONCLUSION:

Planned meetings did not promote total satisfaction of patients with meetings, but improved some aspects of satisfaction, such as the conduct of visitors. The planned meeting is recommended as an alternative for a routine meeting, as it did not affect the physiologic indicators of patients in the intervention group.
Psychometric properties of the Persian version of the “Intergenerational relationship quality scale for aging parents and their children”
Authors: Torabian Maryam , Fadayevatan Reza , Zanjari Nasibeh , Foroughan Mahshid , Harouni Gholamreza Ghaedamini
Published: February 2023

BACKGROUND:

Investigating the status of intergenerational relationships of elderly parents with their adult childen is very important in examining issues related to the status of the elderly such as well being and quality of life and other aspects of elderly life. Giveeen the significance of the topic, the current study aimed to examine the psychometric properties of the Persian version of “Intergenerational Relationship Quality Scale for Aging Parents and Their Children” (IRQS-AP).

MATERIALS AND METHODS:

A total of 463 community-dwelling elders (aged 60 years or older) in Tehran participated in this study through multistage cluster sampling method. To investigate reliability, the construct and convergent validity of the IRQS-AP, confirmatory factor analysis (CFA), and interclass correlation coefficient were done.

RESULTS:

The content validity index was 0.84 for the entire tool. In the CFA, we found the instrument had a four-factor structure and adequate internal consistency. The scale had a significant and positive correlation with the two measures of loneliness and depression. Furthermore, Cronbach's alpha was estimated at 0.77, and the high value of the interclass correlation was 0.82.

CONCLUSION:

The IRQS-AP is a valid and reliable scale that can be used to examine the status of intergenerational relationship quality in Iranian elder population.