bluuebunny/crossref_metadata_2025 huggingface dataset:
Does Serum Kidney Injury Molecule-1 Predict Early Diabetic Nephropathy
Authors: Balu Divya , Krishnan Vasanthan , Krishnamoorthy Vengadakrishnan , Singh R. B. Sudagar , Narayanasamy Senthil , Ramanathan Gnanasambandan
Published: July 2022

Introduction:

Diabetic nephropathy (DN) is a multifactorial disease, one of the most common complications of diabetes and a major cause of chronic kidney disease. Kidney injury molecule-1 (KIM-1) is a sensitive and specific marker of kidney injury as well as a predictor of prognosis.

Objective:

The present study aimed to investigate the usefulness of serum KIM-1 as an early marker of DN.

Patients and Methods:

The present study included total 75 participants, among whom 25 nondiabetic participants were chosen as controls. The 50 diabetic participants were divided into two groups according to urine protein/creatinine ratio (UPCR) as participants with normoalbuminuria (T2DM patients without nephropathy) and microalbuminuria (T2DM patients with nephropathy). The complete blood count, blood glucose, HbA1c, serum electrolytes, and creatinine levels were measured using standard laboratory techniques, and serum KIM-1 levels were measured by sandwich enzyme-linked immunosorbent assay.

Results:

There was a significant difference in the mean serum KIM-1 between the control and diabetics without microalbuminuria (P = 0.0001). Patients with longer duration of diabetes had a higher serum KIM-1 values (P = 0.05 in DM without microalbuminuria; P = 0.007 for DM with microalbuminuria). Serum KIM-1 did not correlate with UPCR in controls (P = [FIGURE DASH]0.167), in diabetics with microalbuminuria (P = 0.487). However, there was a significant correlation observed between UPCR and serum KIM-1 in diabetics without microalbuminuria (P = 0.04).

Conclusion:

The present study observed significantly increased levels of serum KIM-1 in both the diabetic groups compared to controls. Moreover, serum KIM-1 positively correlated with the duration of diabetes. Therefore, serum KIM-1 may be used as an early diagnostic marker to predict nephropathy among diabetes in our population.
Dura-to-Spinal Cord Distance at Different Vertebral Levels in Indian Children
Authors: Garg Heena , Kumar Shailendra , Hemachandran Naren , Goel Prabudh , Kandasamy Devasenathipathy , Bajpai Minu , Khanna Puneet
Published: July 2022

Background:

Neuraxial techniques provide good postoperative analgesia for painful procedures in the pediatric population. However, any injury to the spinal cord can lead to irreversible long-term effects.

Aims:

We aimed to evaluate dura-to-cord (DTC) distance from computerized tomography (CT) images of thoracolumbar spine in pediatric age group (1–16 years) at T8–9, T9–10, and L1–2 interspaces to identify the safe space for epidural insertion in Asian children.

Settings and Design:

It was a retrospective study including 141 children aged 1–16 years who underwent routine CT scan of the thoracolumbar region for unrelated diagnostic indications.

Materials and Methods:

Patients with spinal abnormalities were excluded. Sagittal CT images of the thoracolumbar spine were obtained to calculate the DTC at T8–9, T9–10, and L1–2 interspaces. The measurements at all levels were obtained perpendicular to the long axis of the vertebral body.

Statistical Analysis Used:

Continuous data were depicted as mean with standard deviations. The categorical data were presented as counts with percentages.

Results:

The mean DTC distance at T8–9, T9–10, and L1–2 interspaces was 3.51 ± 0.98 mm (95% confidence interval [CI]: 3.35–3.67), 2.73 ± 0.94 mm (95% CI: 2.57–2.89), and 2.83 ± 1.08 mm (95% CI: 2.66–3.02), respectively. A significant difference was found between the genders at T9–10 (P = 0.02) and L1–2 levels (P = 0.04). No difference in DTC was found in toddlers, preschool children, school-going children, and adolescents. DTC at T8–9 showed a significant correlation with age (R
2 = 0.0479; P = 0.04), weight (R
2 = 0.038; P = 0.02), and height (R
2 = 0.037; P = 0.03).

Conclusion:

Thoracic epidural space can be used in children and adolescents for epidural catheter placement. T8–9 level showed maximum DTC distance and significant correlation with age, height, and weight in CT imaging in the present study.
Effect of Different Doses of Buprenorphine in Combination with Bupivacaine in the Management of Postoperative Analgesia
Authors: Borkotoky Smitirupa , Karan Daisy , Banerjee Swarna , Biswal Prerna , Moda Nupur
Published: July 2022

Background:

Longer duration of analgesia, ceiling effect on respiratory depression, and the antihyperalgesia property make buprenorphine a good adjuvant for managing moderate-to-severe postoperative pain.

Aims:

The aim of this study is to evaluate the onset and duration of postoperative analgesia of three different doses of buprenorphine of 60, 100, and 150 μg given intrathecally along with hyperbaric bupivacaine in patients undergoing lower limb surgeries.

Setting and Design:

This prospective observational study was carried out in the anesthesia department of a tertiary care hospital.

Materials and Methods:

The study included 90 patients of either sex, aged 18–60 years, scheduled for elective lower limb surgery under subarachnoid block. Patients were randomly allocated into three groups (30 each) receiving different doses of buprenorphine. In addition, all patients received 3 mL of 0.5% hyperbaric bupivacaine.

Statistical Analysis Used:

The Chi-square test or Fisher's exact test was used to find out the association between the categorical variables. The association of quantitative variables between the groups was assessed by Kruskal–Wallis test while within the groups was assessed by repeated-measures analysis of variance test.

Results:

Baseline characteristics such as age, gender, and American Society of Anesthesiologist physical status classification were comparable among the three groups. Sensory block, motor block, and total duration of analgesia were significantly higher with higher doses of buprenorphine. The mean difference in the duration of analgesia was comparable in patients receiving 100 μg (720 min) and 150 μg (825 min) of buprenorphine. Bradycardia as a side effect was only in patients receiving 150 μg of buprenorphine.

Conclusion:

Risk–benefit of different doses of buprenorphine suggests that 100 μg may be the ideal dose for a better quality of spinal block and maintaining hemodynamic stability.
A Study to Evaluate the Efficacy of Dexamethasone as an Adjuvant in Ultrasound-Guided Bilateral Superficial Cervical Plexus Block using 0.25% Bupivacaine in Patients Undergoing Thyroid Surgeries under Entropy-Guided General Anesthesia
Authors: Satish Kumar M. N. , Archana M. , Dayananda V. P. , Surekha C. , Ramachandraiah R.
Published: July 2022

Context:

Ultrasound-guided bilateral superficial cervical plexus block (BSCPB) is a technique described for thyroid surgeries for postoperative analgesia as the surgery can cause severe pain and discomfort. Perineural dexamethasone is known to prolong analgesic duration and reduce postoperative nausea/vomiting.

Aims:

To assess the efficacy of dexamethasone as an adjuvant to BSCPB with 0.25% bupivacaine on isoflurane consumption, intraoperative hemodynamic parameters, and postoperative analgesia in patients undergoing thyroid surgeries under general anesthesia.

Settings and Design:

This was a randomized control trial.

Subjects and Methods:

Eighty patients were randomized to two equal groups using random number table into Group A with BSCPB receiving 20 mL of 0.25% bupivacaine and Group B with BSCPB receiving 19 mL of 0.25% bupivacaine + injection dexamethasone 4 mg in the preinduction period. Hemodynamic parameters, isoflurane consumption, postoperative visual analog scale (VAS) score, and antiemetic effect over 24 h were compared between two groups.

Statistical Analysis Used:

Microsoft excel data sheet, Chi-square test, and independent t-test were used for statistical analysis.

Results:

The intraoperative hemodynamic parameters were comparable between the two groups. There was a significant difference in mean VAS score between two groups from 6 h to 20 h postoperatively. The time of rescue analgesic in Group A was 7.09 ± 1.04 min and Group was 13.19 ± 1.46 min with P < 0.0001. In Group A, 40% had nausea and 35% had vomiting, and in Group B, 7.5% had nausea and 5% had vomiting.

Conclusions:

Preinduction ultrasound-guided BSCPB with bupivacaine and dexamethasone provides longer duration of postoperative analgesia and lesser nausea and vomiting compared to bupivacaine alone.
Long QT Syndrome
Authors: Segaran Premkumar , Kamalarathnam C. N. , Murugesan Anitha , Mariappan Vaideeswaran
Published: July 2022

Long QT syndromes (LQTSs) are inherited disorders of abnormal myocardial repolarization. It is characterized by prolonged QT interval, T wave abnormalities, and tachyarrhythmias such as Torsade de Pointes. Previous literature on congenital LQTS in neonates had reported presentations of cardiac arrhythmias leading to sudden death in the postnatal period. We present here a case of a neonate who presented initially with fetal bradycardia; postnatally developed ventricular tachyarrhythmias which after stabilization showed prolonged QT interval in electrocardiography leading to the diagnosis of LQTS due to a rare mutation in the ankyrin B gene. Acute ventricular tachyarrhythmia was managed with lidocaine and magnesium infusion. We used propranolol to sustain the reduction in QT interval to prevent tachyarrhythmias and Torsades de Pointes and thereby sudden death. On follow-up, the infant showed normal growth and neurodevelopment with QT interval maintained below 500 ms on propranolol prophylaxis. Fetal bradycardia can also be one of the initial manifestations of LQTS due to rare genetic mutations involving the ankyrin B gene.
A Case of Neonatal Alloimmune Neutropenia with an Uncommon Presentation
Authors: Silva Marta Ribeiro , Carvalho Vasco , Raposo Filipa , Lima Margarida , Costa Miguel
Published: July 2022

Neonatal alloimmune neutropenia (NAN) is a rare condition in neonates, with an incidence of <0.1%. It occurs when maternal antibodies against neutrophil antigens inherited from the father cross the placenta, destroying the neutrophils of the fetus and/or the newborn. We report a case of a female neonate who started exhibiting scattered petechiae over the trunk and lower limbs, a day after birth. The blood count revealed severe neutropenia and mild thrombocytopenia. Infections were excluded. Flow cytometry analysis confirmed the presence of antineutrophil immunoglobulin G antibodies in the newborn's neutrophil membrane and in the mother's serum. When screened for polymorphisms in the genes encoding for human neutrophil antigens (HNA), we identified HNA-1b and/or HNA-3a as potential causes of the mother/daughter incompatibility. Even though neutropenia is usually self-limiting, neonates with NAN are at risk of developing severe infections. Therefore, early identification of these patients can prevent serious complications.
Cordblood Vitamin A Levels and Intraventricular Hemorrhage Outcomes in Preterm Infants
Authors: Ogbe Emmanuel Augustine , Anigilaje Emmanuel Ademola , Olateju Eyinade Kudirat , Offiong Uduak Mayen , Sanni Usman Abiola , Airede Kaareem Iwunmole
Published: July 2022

Background and Aims:

Intraventricular hemorrhage (IVH) is a major complication of preterm birth and large haemorrhages may yield significant future disability. Although multifactorial, prematurity and low birth weight are the most important risk factors for IVH. Furthermore, being “born too soon” affects the accretion of Vitamin A (VA) which is essential for normal brain development. We sought out to estimate VA nutrient levels among preterm newborn infants at birth and establish any relationship with IVH occurrence and grade severity.

Methods:

Ninety infants were recruited over a 6-month period. VA levels were determined by the enzyme-linked immunosorbent assay using cord blood and IVH was assessed by transcranial ultrasound scan done on the 7th day of life. Data analysis was by the Statistical Package for the Social Sciences IBM (SPSS) version 21. P < 0.05 was considered statistically significant.

Results:

The infants' median interquartile ranges for gestational age, birth weight, and cord blood VA levels were 32 weeks (4.25 weeks), 1580 g (650 g), and 0.31 μmol/L (0.19 μmol/L), respectively. The prevalence of VA deficiency, low VA, and sufficient VA was 67.8%, 25.5%, and 6.7%, respectively. IVH was found in 8 (9.20%) infants, with incidence rates of 5.70%, 2.30%, and 1.10% for Grades I, II, and III, respectively. Although statistically insignificant, the occurrence of IVH was only among infants with abnormal VA status at birth (P = 0.65).

Conclusions:

Despite low median cord blood VA level of preterm infants in this study, there is no impact on IVH occurrence or grade severity. Further study with larger sample size is warranted.
Correlations of demographical and clinicopathological features with patient outcome of pancreatic ductal adenocarcinoma: A retrospective study (2010-2018) from a Libyan Cohort
Authors: Eddfair Mona Mohmed , Abdulrahman Othman , Alqawi Omar , Assidi Mourad , Buhmeida Abdelbaset , Elturki Abdulfattah , Jebriel Abdalla , Elfagieh Mohamed , Ermiah Eramah
Published: July 2022

Objective:

The aim of the study was to study the correlations of demographical and clinicopathological variables of patients with pancreatic ductal adenocarcinoma (PDAC) and evaluate the association of these variables with patients’ survival outcomes.

Patients and Methods:

A retrospective analysis of 123 patients with PDAC were diagnosed and treated at the National Cancer Institute, Misurata, Libya during the 2010–2108 period. Data for demographics, clinicopathological, biological variables, risk factors, presentation, treatment, and survival-related data were collected from the patients’ medical records.

Results:

The mean age of patient was 61.2 years (range: 19–90 years) and most of patients (80.5%) were aged >50 years. For gender distribution, PDAC was more frequent in males (59.3%). Abdominal pain was the most frequent presenting symptom (84.6%) and 78% (96 patients) among them had head tumors. Most patients (80.5%) presented with unresectable tumor at diagnosis. Disease-free survival was better in patients with early stage (P < 0.0001), low-grade tumor (P = 0.001), resectable tumor (P < 0.0001), and with carcinoembryonic antigen levels <5 ng/ml (P = 0.004). Multivariate Cox’s regression analysis showed that tumor stage is an independent poor survival factor (P = 0.002). Age at diagnosis, gender, family history, and position of tumor did not show any significant associations with patient outcome.

Conclusion:

Libyan patients with PDAC had different demographics, clinicopathological, and biological variables. Typically, they presented with unresectable tumor, advanced stages, and had very short survival times. These results urge us to conduct in-depth biomolecular research studies to identify effective early diagnostics and therapeutics biomarkers in order to fight this disease before it escalates.
Histopathological evaluation of minor salivary gland aberrations in oral squamous cell carcinoma
Authors: Bhola Ridhi , Narwal Anjali , Kamboj Mala , Devi Anju , Anand Rahul , Chatterjee Shreya
Published: July 2022

Background:

Oral squamous cell carcinoma (OSCC) is one of the most established oral cancers in India, with high morbidity and mortality. The most common etiological agent associated with it is tobacco (in any form), which releases chemical carcinogens that affect not only the oral epithelial lining but also deep stromal structures such as minor salivary glands. They may cause changes in ductal or acinar part of gland depending on tumor grade, thus providing a fertile soil for tumor growth and recurrence.

Aims and Objective:

To observe the frequency of minor salivary gland changes associated with tobacco as well as to measure the length and depth of ductal involvement in routine tissue sections of OED and OSCC.

Materials and Methods:

A total of 94 hematoxylin and eosinstained archival slides which included cases of well, moderate, and poorly differentiated OSCC and oral epithelial dysplasia were histopathologically evaluated to observe changes in different components of minor salivary gland. Ductal hyperplasia, ductal metaplasia, mucous pooling within duct, acinar degeneration, pattern of malignant cell invasion (single/clusters), inflammatory infiltrate, eosinophilic cuffing around the gland, and glandular/vascular involvement were evaluated in each slide and correlated with different grades of OSCC.

Results:

Ductal hyperplasia, inflammatory cell infiltrate, mucous pooling, and pattern of malignant cell infiltration came out to be statistically significant with the highest percentage of changes being observed in poorly differentiated squamous cell carcinoma > moderately differentiated squamous cell carcinoma> well differentiated squamous cell carcinoma>oral epithelial dysplasia. Further, the results of this study suggest that extension of dysplasia or squamous cell carcinoma from overlying oral epithelium along salivary gland ducts is an uncommon finding. Conclusion: Hence, histopathological interpretation for OED and OSCC should also include changes related to associated minor salivary gland tissue as detection and eradication of the putative precursors are the best way of decreasing the overall morbidity caused by tumors.
Psychosocial impact and coping strategies of frontline healthcare workers in Western Rajasthan during COVID-19 pandemic
Authors: Kumari Kamlesh , Chaudhary Kriti , Chhabra Swati , Bhatia Pradeep , Kamal Manoj , Kishan Rama , Verma Manoj , Kumar Ashok
Published: July 2022

Background and Aims:

Coronavirus disease-2019 (COVID-19) pandemic-related stress is an important but under-rated issue needing attention. Stress and causative factors vary between the regions and individuals depending on the availability of resources, socio-cultural differences, and individual perceptions. We aimed to study the psychosocial impact and coping strategies among the healthcare workers (HCWs) in Western Rajasthan during COVID-19 pandemic.

Material and Methods:

This questionnaire-based observational study, consisting of 59 questions in 6 sections, was conducted to identify stress, causative factors, coping strategies, and experiences of HCWs working in personal protective equipment (PPE). Chi-square test was used to compare the responses between different subgroups.

Results:

Majority of the HCWs felt responsible for treating COVID-19 patients (98.8%), but also felt that it was affecting their safety (81.4%). On subgroup analysis, doctors were found to be more stressed than nursing staff (P = 0.004). Major stressors included concerns about infecting family members and lack of specific treatment for COVID-19 (87.5%). Family support was found to be a major stress-relieving factor (97.3%). Most HCWs suggested that comfortable quarantine stay, adequate supply of PPE, and equipments would help in reducing stress.

Conclusion:

Frontline HCWs in Western Rajasthan were under significant stress during COVID-19 pandemic. We found that stress-causing factors and coping strategies varied between different subgroups based on profession, gender, and age. We recommend conducting such studies in different regions of the world to develop relevant and region-specific strategies to help HCWs cope with stress more efficiently, thereby, strengthening the healthcare system to deal with future pandemics.
Levetiracetam-induced gingival hyperplasia
Authors: James J , Jose J , Gafoor VA
Published: July 2022

Levetiracetam is a new generation antiseizure medication which binds to synaptic vesicle protein SV2A and inhibits the release of neurotransmitters. Gingival hyperplasia is a common side effect of conventional antiseizure medications like phenytoin, but very rare with the newer ones. A 14-year-old boy was started on levetiracetam 250 mg twice daily after a generalized seizure. Five days later he presented with gingival swelling and painful oral aphthae, without lymphadenopathy or systemic symptoms. Blood investigations were normal. After one-month of stopping the drug, the lesions cleared. This case highlights the importance of maintaining good oral hygiene and periodic dental review in patients on antiseizure medications.
Histopathological Assessment of Colonoscopic Biopsies in Patients with Bleeding Per Rectum
Authors: Khassaf Mustafa Bani , Qasim Ban Jumaah
Published: July 2022

Background:

Lower gastrointestinal (GI) bleeding is usually defined as bleeding from the GI tract distal to the ligament of Treitz, and it is usually suspected when patients present with hematochezia, or maroon stools per rectum. It has various causes, which often require colonoscopic biopsy for their conclusive diagnosis.

Aim of Study:

To determine the histopathological changes of colonoscopic/sigmoidoscopic biopsies in patients presenting with bleeding per rectum according to the age, gender, clinical symptoms, and endoscope findings.

Materials and Methods:

In retrospective and prospective studies, 58 cases of colonic tissue paraffin blocks from patients with BPR were collected from Teaching Laboratories of Al-Imamain Al-Kadhumain (AS) Medical City. From each block, sections of 5 um thickness were taken and stained with the routine HandE stain.

Result:

The mean age of the cases with BPR was (44.5 ± 15.7) years, with an M:F ratio of 2.2:1. The most common diagnosis was nonspecific colitis 13(22.4%) cases followed by 7 (12%) cases diagnosed as ulcerative colitis. There is a significant difference in the distribution of final diagnosis according to the patient's gender and age with a p value of (0.03) and (<0.001), respectively. There is a significant difference in the relationship between final diagnosis and colonoscopic findings (P = 0.004).

Conclusion:

In this study, the most common etiology of BPR was nonspecific colitis, ulcerative colitis, hyperplastic polyp, and internal hemorrhoid. There is a significant correlation between final diagnosis and colonoscopic findings.
Detection of Toxoplasma Gondii Oocysts in Contaminated Soils Using Polymerase Chain Reaction Analysis in Duhok City Iraq
Authors: Abdullah Arshad Mohammad , Merza Narmin Saeed , Merza Ahmed Saeed
Published: July 2022

Background:

The impact of the acquisition of Toxoplasmosis from the environment through ingestion of oocyst from the soil, food, or water contamination remains worrisome worldwide.

Objective:

This study aimed to apply the molecular method for the detection of the occurrence of Toxoplasma oocysts by polymerase chain reaction (PCR) from different soil samples in Duhok province, Kurdistan region of Iraq.

Materials and Methods:

In this study, the occurrence of soil contamination with Toxoplasma gondii oocysts was recorded in different Duhok City's areas by collecting 144 soil samples from different places.

Results:

Only seven samples (4.86%) were identified as T. gondii oocysts using microscopical identification and confirmed at the molecular level via PCR analysis using a fragment of 122 bp as a target of B1 gene. No significant difference was observed among soil types; parks showed the highest percentage 2.77%, followed by playgrounds (1.38%), whereas rubbish dumps accounted for 0.96%.

Conclusion:

The current study showed, a low percentage of T. gondii oocysts are recorded in soil samples as compared with other studies worldwide, but there is still the risk of infection among people who ramble at these places remains, especially among children who play with soil at these places.
Patients Characteristic, Indications, and Complications of Permanent Pacemaker Implantation
Authors: Ahmed Mousa Haji
Published: July 2022

Background:

Permanent pacemaker implantation is a relatively safe procedure that significantly improves morbidity and mortality among patients with bradyarrhythmias. This study was conducted to determine the patients’ characteristics, indications, and complications of pacemaker implantation.

Materials and Methods:

This was a single-center, prospective study conducted in Azadi Heart Center, Duhok, Iraq between March 2013 and March 2020. All patients who had indications for permanent pacemaker implantation according to the current guidelines (AHA/ACC) were included and followed up for at least 1 year.

Results:

The study included 396 patients (242 males [61%] and 154 females [39%]) with a mean age of 65 ± 16 years. The most common presenting symptom was dizziness (63%). Atrioventricular block was the most common indication for pacing in 249 cases (63%), followed by sick sinus syndrome (SSS) in 138 patients (34.8%). The most common mode of pacing was DDD in 234 patients (59%). Among all patients undergoing permanent pacemaker implantation, 17 patients (4.25%) developed early and late complications. The most common early complication was pocket hematoma seen in four patients (1%), followed by pneumothorax in three patients (0.75%). Among late complications, painful shoulder was the most common affecting four patients (1%).

Conclusions:

Pacemaker implantation is a relatively safe procedure with a low complication rate. Elderly males were the most common group receiving permanent pacemaker. Dual-chamber (DDD) pacing mode was the most commonly used mode.
Knowledge, Attitude, and Practice of Junior Doctors about Thalassemia in Babylon Province
Authors: Baqer Ola Musadaq , Al-Humairi Ameer Kadhim
Published: July 2022

Background:

Thalassemia is a chronic condition that is caused by hereditary defects in hemoglobin production. Thalassemia is classified into two major categories, named α- and β-thalassemia, according to the hemoglobin gene defect. Premarital screening in the family members, followed by prenatal diagnosis is the most effective strategy for control of thalassemia. The most important thing is the determination of the traits or carriers of thalassemia. In our country, doctors acquired knowledge about thalassemia when they were students in medical college and after graduation, they worked in different hospitals. Some of them had worked in the thalassemia unit whereas others had not.

Objectives:

To assess the knowledge, attitude, and practice of junior doctors about thalassemia in Babylon province.

Methodology:

A cross-sectional study was conducted on 200 junior doctors (resident doctors and permanent doctors) who had different years of experience and places of work in Babylon province. The knowledge, attitude, and practice were assessed according to scoring by a group of researchers.

Results:

A cross-sectional study of 200 junior doctors (resident and permanent doctors), whose age ranged from 24 to 34 years with a mean age of (27.5 ±2.27) years. Most of the junior doctors were females: 145 (72.5%) worked in the emergency department 107 (53.5%). There were 92 (46%) junior doctors who possessed adequate knowledge about thalassemia. There were a significant association between knowledge and age, position/job, and smoking: P = 0.01, 0.02, and 0.04, respectively. The doctors had a positive attitude and good practice about thalassemia, 65 (32.5%) and 84 (42%) respectively. Regarding attitude, there is a significant association between it and position/job, P = 0.02 and in practice there is a significant association between it and gender, which is more in females (P = 0.02).

Conclusion:

The doctors had adequate knowledge, positive attitude, and good practice about thalassemia: 92 (46%), 65 (32.5%), and 84 (42%), respectively.
Medical and Social Analysis of Preschool Children Under the Age of Six Years at Secondary and Tertiary Care after Home Accidents in Hilla City
Authors: Nsaif Aya Kadium , Al-Joborae Sijal Fadhil Farhood
Published: July 2022

Background:

Accidents mainly occur at home, children are the most vulnerable to in any household.

Objectives:

The goals of this study were to identify the commonest causes of home accidents that necessitate secondary and tertiary care admission. And to find out social variables related to home accidents.

Patients and Methods:

It is a descriptive hospital-based cross-sectional study which was carried out on a convenient sample of 200 preschool children who were cared for Emergency Department in Babylon Maternity and Pediatrics Hospital and Imam Sadik General Teaching Hospital whose mothers accepted to participate in this study. It was conducted over a period of four months from April 1 to August 1, 2021. Data were collected through interviewing the participants who were asked to give their verbal consent to a structural questionnaire containing information about sociodemographic factors, child, and family variables. The information was analyzed using SPSS version 24.

Result:

The rate of home accidents (falls and blows by forceful sticks) among children under the age of six years were 55.50% and 24.50%, respectively. From the different investigated factors, Paternal educational level showed significant relation to home accidents, and other variables (maternal educational level, number of family members, and home size) were found to be risk factors for home injuries.

Conclusion:

Falls were the commonest cause of unintentional injuries; in children, home accidents are still the major problem and jeopardize the lives of children. Home accidents among children under the age of six years are increasing and this issue requires more attention and effort.
Visual Evoked Potential Findings and Correlation between Visual Evoked Potential and Clinical Severity in Children with Autism Spectrum Disorder
Authors: Hamdan Farqad Bader , Shareef Hula Raoof , Jasim Hamida Salim
Published: July 2022

Background:

Autism spectrum disorder (ASD) is a heterogeneous behavioral disorder that is characterized by qualitative deficits in social communication and interaction and restricted, repetitive behavioral patterns, activities, and interests. For an optimum outcome in children with autism, early intervention (preferably before three years of age) is essential. Hence, there is a critical need to improve the awareness of ASD to enable earlier detection and intervention. The present study aims at achieving the following: (1) Investigating neural transmission within the visual system using visual evoked potentials (VEPs) as an index of the myelination process of the visual pathway. (2) Correlating the changes in the VEPs with the clinical severity of autism. (3) Investigating the possible gender differences in VEPs in autistic children.

Materials and Methods:

The study was conducted on 60 preschool children (11 females and 49 males) who were recruited from the autism center and the pediatric neurology ward and who met the DSM-V criteria for autism in the Pediatric Hospital for the period from 12 December 2019 to 1 June 2021. Their mean age was 4.5±1.17 years. Another 50 (40 males and 10 females) age- and gender-matched normally developed children served as the control group. Both groups were subjected to a detailed history, as well as complete physical and neurological examinations. The VEPs were assessed for all of them. The autistic children were excluded from the study if they had any motor, visual impairment, inborn errors of metabolism, epilepsy, other chronic medical or neurological disorders, or if they were taking medications during the period of study.

Results:

The P100 wave latency of the VEPs was significantly prolonged in both eyes of autistic children as compared with that of the control group. The N75-P100 amplitude was significantly lower in the left but not the right eye of patients when compared with those of normally developed children. Neither the P100 wave latency nor the N75-P100 amplitude of both eyes was associated with the gender or severity of illness.

Conclusion:

There are distinct changes in VEPs in autistic children, especially the abnormal prolongation of conduction time, suggesting that autistic children may have brainstem and visual pathway dysfunction. Gender and disease severity score have no impact on VEPs.
Méningite purulente survenant au cours d’un lupus simulant un neurolupus
Authors: Karabinta Yamoussa , Mukendi Yannick , Konaté Issa , Fofana Ramata , Dissa Labassou , Seudjip Lydie Joelle Nono
Published: July 2022

Le neurolupus est une complication fréquente et grave de la maladie lupique avec des manifestations cliniques hétérogènes et une difficulté  diagnostique. Nous rapportons une observation clinique d’une méningite purulente dans le contexte d’un lupus érythémateux systémique, chez une  jeune patiente de 29 ans, faisant suspecter à priori un neurolupus. L’examen clinique a retrouvé des lésions cutanées lupiques, un syndrome  méningé dans un contexte fébrile. Le bilan biologique a révélé la présence des anticorps antinucléaires, une hyperneutrophilie, un liquide  céphalorachidien d’aspect trouble caractérisé par une hypoglycorachie, une hyperprotéinorachie et la présence des méningococques. Le diagnostic  d’une méningite bactérienne sur un terrain de lupus érythémateux a été retenu. Sous l’antibiothérapie prescrite, l’évolution du syndrome méningé  était favorable. Cette observation clinique en discussion, démontre que tout syndrome neuro-méningé chez un patient lupique n’est pas forcément  un neurolupus.

 

English title: Purulent meningitis occurring during lupus simulating neurolupus

Neurolupus is a frequent and severe complication of lupus disease with heterogeneous clinical manifestations and difficult diagnosis. We report a  clinical observation of purulent meningitis in the context of systemic lupus erythematosus in a 29- year-old female patient, raising a priori suspicion  of neurolupus. The clinical examination revealed skin lesions of lupus; a meningeal syndrome in a febrile context. The biological assessment found  the presence of antinuclear antibodies, a cerebrospinal fluid with a turbid appearance characterised by hypoglycorrhagia, hyperproteinorrhagia and  the presence of meningococci. The diagnosis of bacterial meningitis in lupus erythematosus was retained. The patient was treated with  antibiotics and the meningeal syndrome evolved favourably. Although neurolupus is a major complication of lupus disease, it should be recognised  that not every neuro-meningeal syndrome in a lupus patient is neurolupus.
Pathomimie mimant un érysipèle : une observation clinique
Authors: Sof Kaoutar , Daflaoui Hanane , Ragragui Hanan , Zizi Nada , Dikhaye Siham
Published: July 2022

La pathomimie cutanée est un trouble de conduite qui se manifeste au niveau de la peau, qui représente un challenge pour le dermatologue. Elle  nécessite une prise en charge multidisciplinaire associant le dermatologue et le psychiatre. Nous rapportons, le cas d’une patiente âgée de 39 ans,  gauchère, suivie en psychiatrie pour un trouble obsessionnel compulsif depuis deux ans sous thérapie comportementale, admise aux urgences ;  pour une grosse jambe traitée initialement comme dermo-hypodermite non nécrosante sous antibiothérapie orale et locale avec un échec  thérapeutique. Le diagnostic de pathomimie a été suspecté et la patiente a été mise sous pansements occlusifs. L’évolution était marquée par la  cicatrisation des lésions. La patiente a été ensuite adressée en psychiatrie pour des séances de psychothérapie. Ce cas souligne l’importance des  antécédents et du contexte du patient pour établir un diagnostic.

 

English title: Pathomimia mimicking erysipelas: a case report 

Cutaneous pathomimia is a behavioral disorder that manifests on the skin. It represents a challenge for the dermatologist and requires  multidisciplinary management involving the dermatologist and the psychiatrist. We report the case of a 39-year-old female patient, left-handed,  who was followed in the Psychiatry Service for an obsessive-compulsive disorder for two years under behavioral therapy. She was admitted in the  emergency for an erythematous leg and initially treated as non-necrotizing dermo-hypodermitis by oral and local antibiotic therapy with therapeutic  failure. The diagnosis of pathomimia was suspected and occlusive pads were placed on the lesions. The evolution was marked by the healing of the lesions. The patient was referred to the Psychiatry Service for psychotherapy. Our case highlights the importance of the patient's  history and background in the diagnosis of this behavioral disorder.
Déclenchement spontané du travail d’accouchement sur une grossesse à terme d’un foetus anencéphale : une observation clinique inhabituelle
Authors: Matega Teddy Habiragi , Neema Yvette Ufoymungu , Juakali Jean-Jeannot Syhalikyolo , Katenga Gédéon Bosunga
Published: July 2022

Le stress foetal survenant au terme de la grossesse, lié au pic de production de la corticotropin releasing hormone, considérée comme l’horloge  placentaire, est le déclencheur spontané du travail d’accouchement par stimulation de l’axe corticotrope. Ce mécanisme, cependant, par défait de  synthèse de l’hormone adrénocorticotrope secondaire à l’aplasie hypothalamo-hypophysaire fait défaut chez le foetus anencéphale. En effet,  l’anencéphalie s’accompagne presque toujours du dépassement de terme de la grossesse en absence de l’hydramnios. Par contre, associée à ce  dernier, elle conduit à un accouchement prématuré. Nous rapportons un cas de déclenchement spontané du travail d’accouchement sur une  grossesse de trente-huit semaines et un jour. La gestante avait une circulation veineuse collatérale au niveau de la paroi abdominale, la hauteur  utérine était de 41 centimètres, l’échographie réalisée avait objectivé un foetus anencéphale associé à un polyhydramnios. Le nouveau-né était  décédé sept minutes après l’accouchement. Ainsi, bien que très rare, l’anencéphalie associée au polyhydramnios peut atteindre le terme de la  grossesse. L’échographie du deuxième trimestre devrait être réalisée chez toute les gestantes pour dépister cette malformation et arrêter l’évolution  de la grossesse, car cette pathologie est incompatible avec la vie extra-utérine.

 

English title: Spontaneous induction of labor in a full-term pregnancy of an anencephalic fetus: an unusual case report

The fetal stress occurring at the end of pregnancy is linked to the peak of corticotropin-releasing hormone which is considered as the marker of  placental clock. This stress is the spontaneous trigger of labor by stimulation of the corticotropic axis. In the anencephalic fetus, this mechanism is  lacking due to the absence of synthesis of adrenocorticotropic hormone secondary to hypothalamic-pituitary aplasia. In fact, anencephaly is almost  always accompanied by the post-term pregnancy in the absence of hydramnios. However, when associated with hydramnios, it leads to premature  delivery. We report a case of spontaneous induction of labor in pregnancy of thirty-eight weeks and one day. The pregnant woman had a collateral  venous circulation in the abdominal wall, the uterine height was 41 centimeters, and the ultrasound scan showed an anencephalic fetus associated  with polyhydramnios. The newborn died seven minutes after delivery. Therefore, although very rare, anencephaly associated with polyhydramnios  can reach term. The second-trimester ultrasound should be performed in all pregnant women to detect this malformation and stop the evolution of the pregnancy because this pathology is incompatible with extrauterine life.
Geotechnical Modeling of Optimal Pit: West Limb of the Tarkwaian of Ghana
Authors: Affam M. , Balegha M.
Published: July 2022

Tarkwa Gold Mine is depleting its reserves to the east of the mine, on the Tarkwaian paleo placer deposit. It has, as a result embarked on vigorous near mine exploratory works to the west of the concession for reserve generation. Results indicate gold mineralisation of economic interest. The Mine seeks to provide optimal slope design that would satisfy shareholders and employees in the context of safety, ore recovery, and financial returns. Rock Mass Rating (RMR) and subsequent adjustment to obtain the Mining Rock Mass Rating (MRMR) was done for rock characterisation. The ratings for the various geotechnical zones ranged from 40.91 to 67.72 and rated from fair to very good. Kinematic stability analyses were performed for all the three design sectors using stereographic techniques to determine the failure modes kinematically possible in bench and/or multi-bench scale slopes. Multi-bench scale planar and wedge failures were kinematically possible in all sectors. Limit equilibrium analysis gave factors of safety that exceeded the minimum acceptable factor of safety of 1.05 for completely weathered material and 1.20 for fresh rock. The probability of failure was however less than 5%. Pit wall architecture for the geotechnical domains were 8 meters, 18 meters, 75 degrees for the berm width, bench height, and bench face angle respectively. Indicative overall slope angles fell between 50.02 to 59.21 degrees and rated from fair to very good.
Beneficiation of Iron Oxides from Cupola Furnace Slags for Arsenic Removal from Mine Tailings Decant Water
Authors: Koomson B. , Koomson J. A. , Asiam E. K.
Published: July 2022

Large volumes of ferrous metallurgical slags (FMS) are generated annually as waste materials from metal extraction, purification, casting and alloying processes worldwide. Some attempts have been made to use bulk FMS in metal precipitation and concrete works but little success has been achieved because of unstable precipitates and volume expansion of concrete structures. As a result, significant quantities of FMS are still disposed in landfills. This disposal leads to land conflicts and poor environmental practices. The present study focuses on the characterization and separation of iron oxide from selected bulk FMS (Cupola Furnace Slag - CFS) obtained from Ghana into constituent components for use as engineering materials. Quantitative X-ray diffractometry was used to determine the mineralogy of CFS. Iron oxide morphology and spot composition in the CFS were determined using scanning electron microscopy, combined with energy dispersive spectroscopy. The inductively coupled plasma-optical emission spectrometry was used to ascertain the chemical composition of CFS after acid digestion. Wet low intensity magnetic separation technique was employed for beneficiating iron oxides from the CFS. It is shown that the CFS is amorphous and consist of ferrous and non-ferrous material. Results of the investigation confirmed that ferrous materials in the slags can be separated using magnetic separation technique. The study further confirmed that fine grinding (- 75 µm) liberates the magnetic portions of the slag efficiently, and as such, they can be recovered using a low magnetic field. The recovery was 99.04 % and the concentrates obtained from the beneficiation process consist primarily of pigeonite, quartz, magnetite and jacobsite.  The beneficiated concentrates have the capacity to adsorb arsenic from mine effluent. This study has demonstrated that, slags can be utilized as secondary resources rather than a waste.
Assessment of Daily and Annual Ultraviolet Radiation Doses Received by Outdoor Workers in Southwestern Nigeria
Authors: Olowookere C. J. , Otiko M. M. , Akintomide J. , Aladeniyi K. , Okunlola O. O.
Published: July 2022

A certain degree of solar light illuminance could prevent myopia in children. However, UV radiation (UVR) serves as mutagen and a non-specific damaging agent. Ultraviolet radiation can initiates and promote tumor growth, essentially under the skin. To this end, this study was designed to assess daily and annual UVR exposures of outdoor workers (OWs) in Southwestern Nigeria by using standard methods. Results obtained show that the mean daily and annual UV exposure were found to be 1.23 mW/cm2 and 319.8 mW/cm2 respectively. The mean predictive protection factor (PPF) for glass, trampoline and neem shade were found to be 43.84%, 98.69 % and 92.88 % respectively. This indicates that trampoline used to build tent has the greatest PPF followed by the shade of a neem tree. Results of this study also show that peak UVR exposures occur between 1400 and 1600 hours. Based on the findings of this study, outdoor workers could prevent UVR overexposure during the peak exposure period by working under the shade of a tree or wear effective UVR shields such as trampoline hat.
Effect of Moringa oleifera Leave Meal on Digestibility and Haematological Parameters, and Health Status of Doe Rabbits
Authors: Osunkeye O. J. , Akinduro V. O. , Adedire A. O. , Adewumi A. A. , Aluko O. P. , Omole A. J. , Oyedokun A. J.
Published: July 2022

The study involved the use of the Moringa oleifera leaf meal (MOLM) to feed doe rabbits and determine its effect on their nutrient digestibility and haematological indices. Five (5) treatment diets were formulated to contain MOLM inclusion levels of 0% (control), 25%, 50%, 75% and 100%. Forty five (45) rabbits of same sex were distributed randomly into five groups of nine animals and replicated three times per treatment having between 24 – 28 weeks of age with initial weight of about 1800 – 2400 g per animal. The does were provided with feed and water throughout the experimental period which lasted eight weeks. Analysis of the Moringa leaf meal (MOLM) on DM basis indicated that the leaves contained 92.15% Dry Matter, 12.85% Crude Protein, 5.10% Ether Extract, 6.57% Crude Fibre, 11.20% Ash, 64.28% Nitrogen Free Extract. The apparent digestibility of CP, CF, EE and NFE were affected (P<0.05) by the graded levels of MOLM inclusion except for the dry matter. The haematological parameters like packed cell volume, white blood cell, lymphocyte, neutrophil and monocyte vary significantly (p<0.05) between treatments. MOLM could be included in rabbit feed at an inclusion level of 25% without any adverse effect on the digestibility performance while blood indices of doe rabbits improved with increasing levels of Moringa oleifera.
Evaluation of Physical and Mechanical Properties of Selected Wood Species obtained from Saw Mills in Akure, Nigeria
Authors: Ekundayo O. O. , Arum C. , Owoyemi J. M.
Published: July 2022

The strength and sorption properties of selected wood species obtained from saw mills in Akure Nigeria were investigated based on key index properties such as density, bending strength and dimensional stability using appropriate standard experimental techniques. Data obtained from the experimental investigation revealed that the wood species ranged from low density 442.8 kg/m3 for Terminalia superba (Afara), through medium density 464 kg/m3 and 552.8 kg/m3 for Pycnanthus angolensis (Akomu) and Gmelina arborea (Gmelina) respectively, to high density 635.7kg/m3 and 678.2 kg/m3 for Milicia excelsa (Iroko) and Stereospermum acuminatissimum (Omo cedar) respectively. The bending strength values obtained qualified the wood species classification into low bending strength (25 N/mm2 – 75 N/mm2 ) for Afara, Akomu and Gmelina and the medium static bending strength in the range (75 N/mm2 – 125 N/mm2) for Iroko and Omo cedar. Furthermore, results of volumetric shrinkage and swelling are 7.21%: 5.04%, 7.75%: 5.26% and 7.84%: 6.69% for Afara, Akomu and Gmelina respectively while Iroko and Omo cedar recorded 10.95%: 7.84% and 11.08%: 11.08%. These updated results could be useful for wood selection for building construction application; for structural members in roofing, posts and beams.