bluuebunny/crossref_metadata_2025 huggingface dataset:
How Joliet Junior College Leaders Use Design-Thinking to Create and Implement Major Initiatives
Authors: Namuo Clyne G. H. , Farmer Yolanda , Rohder-Tonelli Kelly
Published: April 2024

Joliet Junior College (JJC), founded in 1901, holds the distinguished title of being the first public community college in the United States. Its establishment marked the inception of an educational revolution, aimed at providing accessible higher education to a broader, localized demographic. Initially conceptualized by William Rainey Harper, JJC set the foundation for a national movement, creating pathways for students to pursue higher education in a community-centric environment. This chapter delves into the history and pioneering spirit of JJC, exploring its early challenges and curriculum development, its role as a blueprint for subsequent community colleges, and its ongoing commitment to innovation and strategic resilience in the face of evolving educational landscapes, namely through design-thinking methodologies to impact strategic positioning.
Algorithmic Insights
Authors: Yalamati Sreedhar , Vaddy Rama Krishna
Published: April 2024

This chapter delves into the profound impact of artificial intelligence (AI) and machine learning (ML) in practical, real-world applications. Unveiling the transformative capabilities of algorithms, the exploration covers a spectrum of industries where AI and ML bring tangible benefits. From enhancing decision-making processes to optimizing operations, the chapter navigates through the practicalities of integrating algorithmic solutions. The discussions delve into specific applications, illustrating how these technologies drive innovation and efficiency. As the authors unravel the nuanced role of algorithms, readers gain a comprehensive understanding of the dynamic landscape where AI and ML contribute to solving complex challenges and unlocking new possibilities.
AI-Driven Modeling
Authors: Palakurti Naga Ramesh , Kolasani Saydulu
Published: April 2024

This chapter embarks on a comprehensive exploration of the dynamic landscape of AI-driven modeling, tracing the journey from conceptualization to practical implementation. The narrative unfolds by elucidating the foundational concepts underpinning AI-driven modeling, providing a nuanced understanding of the principles that drive its transformative power. From machine learning algorithms to deep neural networks, the chapter navigates through the diverse array of modeling techniques, offering insights into their strengths, limitations, and real-world applications. Moving beyond theoretical considerations, the chapter delves into the practical aspects of implementing AI-driven models. Through a series of case studies and examples, readers gain valuable insights into the intricacies of model development, training, and optimization. The exploration extends to model interpretation and explainability, addressing the critical need for transparency in AI-driven decision-making.
Data Analysis Using IoT Technologies for Enhanced Healthcare Decision-Making
Authors: Mahajan Radhika , Arora Renuka
Published: April 2024

The integration of internet of things (IoT) technologies has redefined the landscape of healthcare data analysis, offering unprecedented opportunities for informed decision-making. This chapter delves into the transformative potential of IoT-enabled data analytics in healthcare contexts. Leveraging IoT devices, a wealth of real-time patient data was seamlessly collected, ensuring a 95% data collection rate and achieving 97.5% accuracy in vital signs monitoring. The predictive models, empowered by IoT-driven analytics, demonstrated an average accuracy of 89.3% in forecasting patient conditions and onset of potential health issues. Moreover, operational efficiencies were evident with a 30% reduction in response time to critical patient alerts, a 25% decrease in operational costs, and a notable 20% improvement in patient outcomes. These quantifiable outcomes highlight the substantial impact of IoT technologies in optimizing healthcare decision-making, enhancing patient care, and fostering resource-efficient practices.
AI and Influencer Marketing
Authors: Kour Manjit , Kour Rajinder
Published: April 2024

Numerous sectors have been transformed by artificial intelligence (AI), and marketing is no exception. The rise of artificial intelligence (AI) influencers, or virtual people powered by cutting-edge AI algorithms, is one of the newest trends in marketing. These AI influencers are upending conventional marketing approaches and changing how firms interact with their target markets. AI influencers have developed into valuable marketing tools for companies looking to engage customers in a social environment thanks to their increased personalisation, expanded reach, and affordability. The world of social media marketing has been significantly altered by AI and influencer marketing, and this trend is expected to continue. This study examines how AI influencers are revolutionising brand promotion, reshaping the marketing environment, and creating a new industry in this chapter.
Examining Satisfaction Factors among Young Vietnamese Tourists: A Study of Traditional Cuisine in Hue City, Vietnam
Authors: Hoang Nguyen Van , Ninh Dao Thi Thuy , Trung Pham Do Van
Published: April 2024

The satisfaction of tourists plays a crucial role in enhancing the image of a tourist destination and influencing their decision to visit and revisit. Despite numerous global studies on this issue, there needs to be more research on factors influencing tourist satisfaction with traditional cuisine, especially for young Vietnamese tourists in a historic city like Hue, Vietnam. This study surveyed 250 young domestic tourists visiting Hue in early 2023 and included 12 semi-structured interviews with culinary experts, chefs, and tourism businesses. The results of hypothesis testing revealed that factors related to traditional Hue cuisine, such as Culinary Quality (CQ), Service Quality (SQ), Food hygiene and safety (HS), and Fair Price (FP), positively impact Customer Satisfaction (SAT). However, the factor of Restaurant Environment (RE) was rejected. Additionally, the interview results highlighted the significance of traditional Hue cuisine in tourism development. The study proposes policies and solutions to enhance tourist satisfaction with traditional Hue cuisine. This research contributes to formulating management policies and promoting traditional cuisine as a crucial factor in attracting visitors to tourist destinations.
Fitness consequences of feeding-by-remating interactions in female Cerambyx welensii (Coleoptera: Cerambycidae: Cerambycinae)
Authors: Torres-Vila Luis M.
Published: April 2024

The longhorn beetle, Cerambyx welensii (Küster) (Coleoptera: Cerambycidae), is considered a critical factor in oak decline in southwestern Iberia, but populations vary over space and time, depending on several ecological factors. Adults feed on ripe fruits and tree exudates, and evidence suggests that feeding could impact fitness in hot, dry summers, especially under climate change. In the present study, we assessed the impact of adult feeding (sugar-fed, water-fed, or unfed) and remating (monandrous versus polyandrous) on female reproductive output. Lifetime fecundity increased with female size in most feeding–remating combinations. Sugar-fed females achieved the highest longevity and fecundity, unfed females the lowest, and water-fed females had intermediate values. The daily fecundity pattern was strongly dependent on female feeding. Longevity and fecundity of once-mated and remated females were similar in both unfed and water-fed groups; however, in sugar-fed females, remating enhanced fecundity and shortened life span. Preoviposition, oviposition, and postoviposition periods were distinctly affected by both diet and remating. Results show that females require sugar to maximise reproductive output and that a water supply may partially mitigate the fitness decline of unfed females. We conclude that female feeding must be considered to explain C. welensii spatio-temporal occupancy–abundance patterns in oak woodlands.
Alternatives to the P value: connotations of significance
Authors: In Junyong , Lee Dong Kyu
Published: April 2024

The statistical significance of a clinical trial analysis result is determined by a mathematical calculation and probability based on null hypothesis significance testing. However, statistical significance does not always align with meaningful clinical effects; thus, assigning clinical relevance to statistical significance is unreasonable. A statistical result incorporating a clinically meaningful difference is a better approach to present statistical significance. Thus, the minimal clinically important difference (MCID), which requires integrating minimum clinically relevant changes from the early stages of research design, has been introduced. As a follow-up to the previous statistical round article on P values, confidence intervals, and effect sizes, in this article, we present hands-on examples of MCID and various effect sizes and discuss the terms statistical significance and clinical relevance, including cautions regarding their use.
Raiding the raid: a summary of the Brenthurst conference 'the Jameson raid and beyond', 20-22 January 1997
Authors: Jeeves Alan H.
Published: April 2024

No abstract available.
Black territories: Identity, ethnicity and politics
Authors: Leite IIka B.
Published: April 2024

No abstract available.
Role of doxycycline in the treatment of dengue infection: An open-label, randomized, controlled, pilot trial
Authors: Kumar Banothu Vinod , Kamboj Kajal , Pannu Ashok Kumar , Yadav Ashok Kumar , Bhatia Mandip , Saroch Atul
Published: April 2024

Objective:

To measure the effect of doxycycline on inflammatory marker [IL-6, TNF-α, ferritin and C reactive protein (CRP)] levels in patients with dengue infection.

Methods:

A single-centre, open-label, parallel-group randomized controlled trial was done in PGIMER Chandigarh from June 2021 to October 2022. Patients were randomized using a simple randomization process into two groups: the doxycycline treatment group (n=35) and the control group (n=34). Patients in the treatment group were given oral doxycycline 100 mg twice daily for five days along with standard treatment, whereas patients in the control group received only standard treatment. The objective was to measure the effect of doxycycline on inflammatory markers in dengue infection.

Results:

On comparative analysis at day 5, there was a statistically significant reduction in the median values of ferritin and CRP in cases compared to the control group (ferritin: P=0.006 and CRP: P=0.006). No significant reduction was noted in the levels of IL-6 and TNF-α.

Conclusions:

Doxycycline treatment led to a reduction of inflammatory markers in dengue infection.
Characterization of Ocular Sonography Findings and their Relationship to Clinical Features from a South Indian Cohort of Idiopathic Intracranial Hypertension
Authors: Kishore KV , Patwardhan Ameya , Aravinda HR , Mustare Veerendrakumar , Ramakrishnan Subasree
Published: April 2024

Background:

Idiopathic intracranial hypertension (IIH) typically manifests with headache, accompanied by papilledema and visual loss, and has a higher prevalence in females. In recent years, ocular sonography, particularly, measurement of optic nerve sheath diameter (ONSD), is being investigated for diagnosis of IIH.

Methods:

A total of 35 patients over the age of 18 years, fulfilling the modified Dandy's criteria for diagnosis of IIH were included. Patients underwent assessment with magnetic resonance imaging, lumbar puncture, and ocular sonography to measure ONSD and ocular arterial indices.

Results:

The mean ONSD values (in centimeters) in the right eye of patients with IIH was 0.57 ± 0.13, while it was 0.48 ± 0.03 in controls. In the left eye, the mean ONSD value (cm) was 0.59 ± 0.13 in patients with IIH and 0.48 ± 0.03 in controls. ONSD was significantly higher in cases compared to controls (P < 0.001, Welch test). Pulsatility index of the central retinal artery was significantly higher in cases compared to controls (P < 0.001, Welch test). Resistance index of the ophthalmic artery was statistically significant (P < 0.005, Welch test). Receiver operating characteristic curve analysis revealed a cutoff value of 5.1 mm on the right side and 5 mm on the left side had a sensitivity and specificity of more than 80% for IIH diagnosis.

Conclusion:

Our study provides insights into the utility of optic nerve sheath measurements and arterial indices in the diagnosis of IIH in a South Indian cohort. Further research is needed to fully understand the longitudinal relationship of these parameters and treatment outcomes in IIH.
Burning Bright or Burning Out: A Cross-sectional Study on Burnout among Postgraduate Residents in an Eastern Indian Teaching Hospital
Authors: Priyam Pallavi , Mandal Uday Sankar , Sil Abheek
Published: April 2024

Introduction:

Burnout is a concerning clinical syndrome comprising excessive stress, lack of satisfaction, and a feeling of being overworked. In India, postgraduate residents who shoulder the entire burden of patient care, are prone to suffer from burnout. Only a few Indian studies have been carried out to estimate the prevalence of burnout among postgraduate resident doctors. Our study, the first of its kind from eastern India, aims to address this lacuna.

Materials and Methods:

This was a single-institution cross-sectional observational study carried out using an online semi-structured form comprising demographic data and the Maslach Burnout Inventory. Appropriate statistical tests were carried out to analyze the data obtained.

Results:

The study received a response rate of 79.2%. Of the participants, 44.1% were females, 54.9% were males, and 1% identified as other gender. The mean age (standard deviation) of the participants was 28.02 (3.67) years. Overall, 75% of the participants experienced burnout. Younger participants, females, clinical residents, those in a relationship, and 2nd year of residency reported higher emotional exhaustion. Depersonalization was associated with lower age, being in a relationship, metropolitan upbringing, and 2nd year of residency. The lower personal accomplishment was seen in those coming from metropolitan and rural backgrounds.

Conclusion:

Burnout has serious implications on psychological and physical health of the residents. Interventions for effective management will greatly improve the overall mental health and work performance of the junior doctors.
Effect of Intermittent Fasting Interventions for Treatment of Overweight and Obesity in Adults – A Systematic Review
Authors: Lal Teena , Arulkumar S. J. Ajeet , Roopa S.
Published: April 2024

Recent data from the 2019 Global Health Metrics report indicates a troubling trend: more than five million deaths annually can be traced back to health issues related to being overweight or obese. This comprehensive review, scrutinizes the role of intermittent fasting (IF) in improving metabolic functions and aiding in weight loss among the adult demographic. This review, built on the solid foundations of the Cochrane and PRISMA protocols, thoroughly examines a plethora of research concerning IF as a viable approach to combat adult obesity and overweight conditions. Our extensive research canvassed several academic and scientific databases such as PubMed, Embase, PsycINFO, Web of sciences, Scopus and the Cochrane Library, up until the latter part of February 2023, with no barriers on language. We identified 3241 studies, which after deduplication procedures, narrowed down to 3065. Through meticulous evaluation, we shortlisted 386 studies. Ultimately, our synthesis includes 10 research papers with contributions from India (6 studies), as well as individual studies from Pakistan, Saudi Arabia, the USA, and China, collectively observing 845 adults. Our synthesis of the selected research posits that IF provides enduring and beneficial outcomes for adults suffering from obesity and excess weight. The intervention showcases a marked improvement in managing blood glucose, lipid concentrations, insulin sensitivity, and overall cardiovascular functioning. It is also observed that integrating IF with consistent physical activity serves as an effective dual strategy for not only weight control but also for fostering an enhanced state of general health.
Assessment of Asthma Knowledge of Parents of Children with Bronchial Asthma
Authors: Verma Shalini , Awasthi Shally , Gupta Sarika
Published: April 2024

Introduction:

Understanding bronchial asthma plays a crucial role in the management and control of this chronic disease. While good asthma knowledge of the parents helps in better control of the disease in their children, it remains variable among the parents.

Materials and Methods:

This cross-sectional observational study was conducted in the outpatient asthma clinic of a tertiary center. New Castle Asthma Knowledge Questionnaire (NAKQ) were filled out by the caregivers of children (between 7 and 15 years, diagnosed as per global initiative for asthma guidelines) with bronchial asthma, after obtaining the proper consent. The validated Hindi version of the NAKQ questionnaire had a total of 31 questions regarding knowledge, acute asthma attacks, maintenance management, and misconceptions.

Results:

Eighty-five parents responded to the NAKQ questionnaire during this 1-year duration. 58 (68.24%) were fathers, and 27 (31.76%) were mothers, filling out the questionnaires. The knowledge score of the respondents enrolled in the study ranged from 10 to 18, the median knowledge score was 14, and the mean knowledge score of respondents was 14.02 ± 1.93.

Conclusion:

The mean knowledge score of the parents of bronchial asthma patients was found to be low in our setting as compared to other studies where a similar questionnaire was used.
Pulmonary Fissures Including Accessory and Azygos Fissures and their Clinical Significance
Authors: Agrawal Nitin , Bhardwaj Harshita , Chhabra Neeta , Chaudhary Neha
Published: April 2024

Introduction:

The lungs are divided into lobes by oblique and horizontal fissures. Knowledge of extent of completeness of fissures is important for surgical planning. This study highlights the variation in Pulmonary fissures including accessory and azygos fissure and their clinical relevance.

Materials and Methods:

The sample consists of fifty (50) lung specimens (25 right and 25 left), collected from formalin fixed cadavers, which were dissected during undergraduate teaching. The lungs were observed for complete, incomplete, and absent fissures. Additional fissures including accessory and azygos fissures were also observed and findings compared with previous studies.

Results:

Accessory fissure was found in 35% right and 40% left lungs. Horizontal fissure was found to be absent in 30% right lungs. Oblique fissure was found absent in 5% right and left lungs. Four right lungs had azygous fissure. Inferior accessory fissures were found in 15% right lungs. 20% left lungs had both inferior accessory and left minor fissures.

Conclusion:

It is important to assess the incompleteness or absence of fissures, when planning any surgical procedure. Lung fissure variations are frequently encountered during surgical procedures and knowledge of pattern of these fissures is important to avoid and reduce associated mortality and morbidity.
Hypertension and Lifestyle Determinants in Public Transport Drivers: A Sector-specific Study in Coimbatore, Tamil Nadu
Authors: Devarasu Usha , Jayaraj Naveen Prabhu , Sugunadevi G. , Kokila K.
Published: April 2024

Introduction:

Cardiovascular diseases are a leading cause of death worldwide, prompting this investigation into hypertension – a key risk factor – among a vulnerable group, bus drivers, who may be affected by job-related stress and health behaviors.

Materials and Methods:

This cross-sectional analysis evaluated 800 male TNSTC bus drivers from Coimbatore using a multistage sampling method. Interviews, physical measurements, and blood pressure assessments provided the data, which were subjected to comprehensive statistical analysis.

Results:

A concerning 49.9% of drivers were hypertensive, and 27.75% did not have their condition under control. Increased risk was linked with advancing age (those above 51 were 3.28 times more at risk than those under 30), lower educational attainment, familial hypertension history, and lifestyle choices, including sedentary habits, excessive salt consumption, and substance use. A striking correlation was observed between obesity and hypertension (odds ratio: 1.36; 95% confidence interval: 1.09–1.69).

Conclusion:

This research highlights an alarming rate of hypertension within the bus driver cohort, influenced by both modifiable and non modifiable risk factors. It underscores the urgent need for targeted health programs, proactive screenings, and educational initiatives. Expanding the study to other centers will provide a broader context for these findings.
Assessing Treatment Efficacy and Determinants of Outcome in Isoniazid Mono-resistant Tuberculosis Patients: A Prospective Observational Study in Gujarat
Authors: Patel Keyur , Yogesh M. , Makwana Manju , Misra Swati
Published: April 2024

Introduction:

There is a high number of isoniazid-resistant tuberculosis (TB) in India; estimates imply that over 25% of TB patients there are isoniazid-resistant. Hence, the study aimed to evaluate the effectiveness of therapy for patients with isoniazid-mono-resistant TB and the negative effects of the H-mono-resistant TB Regime.

Materials and Methods:

It was a hospital-based prospective observational study from September 2021 to August 2022. Hence, 100 patients diagnosed with isoniazid mono-resistance TB enrolled in this study. After obtaining the prior informed consent of all patients willing to approve the collection and publication of their data, including extensive clinical history and radiological, microbiological, and biochemical investigations, this study included all diagnosed cases of isoniazid mono-resistant TB. A descriptive statistical analysis was done for continuous and categorical variables. Differences in characteristics between participants were tested with logistic regression and cross-tabulation. P <0.05 was considered significant.

Results:

Among 100 patients participated, their mean age was 50.8 ± 3.2 years. About 72 (72%) participants have successful treatment outcomes (cure). Only about 25 (25%) patients had minor adverse drug reactions. Body mass index (16.6 [3.6–74]), substance addiction history (9.5 [3.3–26.9]), previous history of TB (9 [3.3–24.0]), type of lesion (5.3 [1.6–17]), and extent of the lesion (2.6 [1.03–6.07]) in chest X-ray were associated statistically with the treatment outcome.

Conclusion:

The findings suggest that the H-mono-resistance regime is generally well-tolerated, with only a small percentage of patients experiencing nonserious adverse drug reactions, and the overall successful treatment outcome in H-mono patients was 72%. The study also highlights the importance of monitoring drug resistance patterns, particularly for levofloxacin and moxifloxacin, and the need for effective treatment regimens for isoniazid mono-resistant pulmonary TB.
A rare complication of measles infection presented with subacute sclerosing panencephalitis: Report of two cases in India
Authors: Fatima Razeen , Husain Amir , Tabish Iram
Published: April 2024

Rationale:

Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder caused by persistent measles virus infection. SSPE predominantly affects children and adolescents. The symptoms usually develop 6-15 years after measles infection and ultimately leading to death in many cases.

Patient concerns:

Patient 1 presented with cognitive decline and myoclonus and the Patient 2 presented with diminution of vision with myoclonic jerks.

Diagnosis:

Based on the clinical features with a characteristic electroencephalogram pattern and the presence of a high titer of anti-measles IgG in serum and cerebrospinal fluid, these patients were diagnosed as SSPE.

Interventions:

Antiepileptics were started for controlling myoclonus along with supportive treatment.

Outcomes:

Both patients were discharged on antiepileptics and supportive care.

Lessons:

Whenever there are unusual clinical manifestations with unknown vaccination status, SSPE can be suspected and the cerebrospinal fluid should be examined for anti-measles antibodies. Our case study also highlights the importance of universal coverage of measles vaccination. To reduce the incidence of measles and associated deaths, it is important to maintain a high level of immunization coverage for the measles vaccine and to strengthen all the integral components of the national immunization program.
Prognostic value of N–terminal pro B–type natriuretic peptide and troponin I in children with dengue shock syndrome
Authors: Truyen Phuoc Le , Nguyen Phung Nguyen The
Published: April 2024

Objective:

To investigate the contribution of N-terminal pro B-type natriuretic peptide (NT-pro BNP) and troponin I to mortality in children with dengue shock syndrome.

Methods:

A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam. Detailed clinical histories, physical examinations, and laboratory parameters, including NT-pro BNP and troponin I, were recorded. A comparison between survival and non-survival was carried out to identify factors influencing mortality.

Results:

A total of 107 patients with a median age of 9 years were included in the study. Among them, 63.6% (68/107) presented with compensated shock, 36.4% (39/107) had hypotensive shock, 23.4% (25/107) required mechanical ventilation, and 12.1% (13/107) died. The NT-pro BNP levels were 3.9 pmol/L (IQR: 1.9, 10.3) and 15.2 pmol/L (5.8, 46.3), while the median high sensitivity troponin I levels were 20 pg/L (6, 95) and 62 pg/L (12, 325) at the first and second measurements, respectively. The mortality group exhibited higher rates of hypotensive shock, prolonged shock, lactate levels, liver damage, NT-pro BNP, and troponin I levels. Hypotensive shock (OR 12.96, 95% Cl 2.70-62.30, P=0.004), prolonged shock (OR 39.40, 95% CI 6.68-232.70, P<0.001), AST > 1 000 IU/L (OR 9.50, 95% CI 2.63-34.34, P=0.041), and NT-pro BNP > 7 pmol/L (OR 44.40, 95% CI 5.44-362.20, P=0.001) were identified as predictive factors for mortality in dengue shock syndrome.

Conclusions:

The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome.
Methotrexate-induced Hyperpigmentation in a Patient with Rheumatoid Arthritis
Authors: Alaauldeen Samaher Ibrahim , Mayis Hussam Saleh , Bawazeer Amani , Radhwi Zuhair , Bamerdah Shahad , Hafiz Waleed A.
Published: April 2024

Rheumatoid arthritis (RA) is a chronic progressive systemic and inflammatory disease affecting the lining of the synovial membranes, leading to inflammatory polyarthritis and extraarticular involvement in a symmetrical way. RA is known to be an autoimmune condition, which means that the body’s natural self-defense system gets confused and starts to attack the body’s healthy tissues. Treatment of RA is usually with disease-modifying antirheumatic drugs (DMARDs), but if left untreated, the risk of morbidity, mortality rate, and socioeconomic burdens will increase. Methotrexate (MTX) is one of the folic acid antagonists and one of the conventional synthetic DMARDs. It is the most common drug for the treatment of RA. MTX is a dihydrofolate reductase inhibitor that decreases purine metabolism, which affects cell division. MTX can also cause different types of cutaneous side effects, such as acral erythema, urticaria, ulcerations of the oral mucosa, burning sensation of the skin, multiform erythema, vasculitis, and hyperpigmentation to sun-exposed area. In this case report, we describe a 31-year-old woman who had RA and then developed MTX-induced hyperpigmentation.
Victim of Neglect: Juvenile Spondyloarthropathy (Juvenile-onset Ankylosing Spondylitis)
Authors: Sindagi Sagar Mallappa , Singh Harshita , Mayanglambam Sonika , Gurtoo Anil , Pangtey Ghan Shyam , Bansal Priya
Published: April 2024

Spondyloarthropathy refers to a group of overlapping disorders that include spondylitis, sacroiliitis, asymmetrical peripheral arthritis, and enthesitis. If the onset is before 16 years of age, the condition is known as juvenile-onset spondyloarthropathy. We report a case of a 20-year-old male, who presented with history of pain in the left hip joint for 5 years, and pain in the right hip joint for the last 4 months. Flexion deformity of the left hip joint was noted at presentation. He was advised hip replacement at another center. A much delayed rheumatological evaluation revealed bilateral sacroiliitis, eye features of old iritis, and human leukocyte antigen B27 positivity. A positive family history was also present. He was diagnosed as a case of juvenile-onset ankylosing spondylitis and started on appropriate treatment. Timely recognition and management of juvenile spondyloarthropathy go a long way in preserving joints and quality of life.
Systemic Lupus Erythematosus Patients in the Qassim Region, Saudi Arabia: Insights on Peripheral Nervous System Involvements
Authors: Alrashdi Mousa Nasser , Alharbi Aeshah Menawer , Algubllan Lamees A. , Alrasheedi Sami M. , Alkhdairi Ahmad , Alzweihary Ali M. , Alrumayh Fahad Mansour , Alhemedy Areen Mohammad , Alrasheedi Ibrahim Mohammad , Alrashidi Yousef Duhaim Abdulrahman , Alorini Rasha Mohamed , Alobaid Njood Mohammed
Published: April 2024

Background:

Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with diverse clinical manifestations. This study aimed to investigate the prevalence, clinical features, and risk factors associated with peripheral nervous system (PNS) involvement in SLE patients.

Materials and Methods:

This study encompassed a retrospective analysis involving 377 SLE patients diagnosed according to the European Alliance of Associations for Rheumatology/American College of Rheumatology criteria at Qassim region in Saudi Arabia, conducted through a meticulous chart review facilitated by proficient data collectors. A structured data collection form/checklist, incorporating explicit definitions and instructions, was utilized for extracting information from patient files, papers, and databases. Additionally, the SLE Quality of Life Questionnaire was employed to evaluate the quality of life among the participants. A multivariate logistic regression model was employed to identify independent predictors of PNS involvement.

Results:

Distinct clinical patterns were observed in SLE patients with PNS involvement, including a higher prevalence of nonscarring alopecia, acute cutaneous lesions, oral ulcers, and seizures. Diabetes and chronic kidney disease emerged as significant positive predictors for PNS complications. Hematological abnormalities, renal involvement, and vitamin deficiencies were prevalent, contributing to an overall poor quality of life among these patients.

Conclusion:

This study underscores the need for heightened clinical awareness of PNS complications in SLE, emphasizing the impact of diabetes and chronic kidney disease as significant risk factors. Early detection and targeted interventions are crucial to improving outcomes and enhancing the overall quality of life for SLE patients with PNS involvement.
Utility of sUPAR as a Novel Biomarker for Stratifying Rheumatoid Arthritis Patients in Remission
Authors: Kakar Atul , Choudhury Sangeeta , Chaturvedi Ved , Tripathi Shikhar , Rajput Pooja Rani , Hasan Rizwana
Published: April 2024

Introduction:

Soluble urokinase plasminogen activator receptor (SuPAR) is a novel biomarker studied in conditions such as infections and malignancies. There is a paucity of data on suPAR levels in patients in RA clinical remission. A hypothesis-driven study was conducted to determine the level of suPAR, which will aid in the stratification of patients in remission.

Methodology:

This observational pilot study included 48 subjects (24 rheumatoid arthritis [RA] patients in clinical remission as per the American College of Rheumatology criteria and 24 age-matched healthy individuals). 28-Joint Disease Activity Score (DAS28) calculator was used to calculate disease activity. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and plasma suPAR levels were assessed using suPARnostic® ELISA Assay kit (ViroGates, Denmark). The inflammatory parameters such as CRP, ESR, and suPAR were recorded at the time the patients were defined to be in clinical remission.

Results:

The median of suPAR level among cases in remission was 4.94 ng/mL and in controls was 3.54 ng/mL. The level of serum suPAR among RA remission patients was significantly higher (P < 0.001) than in healthy individuals (P < 0.001). The median of DAS28 score was 2.10, ESR 23, and CRP was 2.66. Nonparametric analysis (Spearman’s rho test) showed a significant correlation (P = 0.008) between DAS28 and ESR. The receiver operating characteristic showed area under the curve of 0.954 with sensitivity 83.3%, specificity 100%, negative predictive value 84%, and positive predictive value 100%.

Conclusion:

High suPAR levels among patients with clinical remission of RA demonstrate that these patients do possess baseline inflammatory status and hence continued treatment is required despite normal to mild range of ESR, CRP, and/or DAS 28 score. Thus, suPAR is a prognostic biomarker that can aid in better therapeutic management to patients with RA remission.
Cerebrospinal fluid biomarkers of demyelination in pediatric population
Authors: Metwally Hussein M.H. , El-Sheshiny Ahmed Hassan , Ahmed Ali M. , Attalla Hams A.
Published: April 2024

Back

ground Many cerebrospinal fluid (CSF) biomarkers were reported to be associated with demyelinating diseases in adults. Some of these biomarkers are chitinase 3-like 1 (CHI3L1), oligoclonal bands, and neurofilament light chain (NFL). We aimed to investigate the association of CSF CHI3L1 and NFL with demyelination disorders in pediatric patients.

Patients and methods

All children with age less than 18 years who came to our department with possible demyelinating of neuroinflammatory disorder from the duration between 2009 to 2019 were included in the study. Enzyme-linked immunosorbent assays were used for the analysis of the needed values.

Results

The data of 97 children were retrieved, and they were categorized as follows: patients with a demyelinating disease (n=17), patients with inflammatory neurological disorders (n=25), patients with systemic inflammatory disorders (n=9), patients with other neurological disorders (n=28), and normal pediatric population (n=18). There was a significant difference between these groups regarding the CSF level of CHI3L1 and NFL, as they were significantly higher in demyelinating disorders rather than other groups.

Conclusion

The levels of CHI3L1 and NFL in the CSF showed the diagnostic value in demyelinating disorders of pediatric populations and would be effective in distinguishing between different demyelinating disorders.
Study the role of dyslipidemia in cases of neuropathy with type 2 diabetes mellitus
Authors: Ali Hossam Abd El Monem , Al Adl Ahmed Salama
Published: April 2024

Background

Diabetic neuropathy is one of the most common neurological diseases. Dyslipidemia is very common in diabetic patients and thought to add to the effect of diabetes on peripheral nerves.

Objectives

To assess the effect of dyslipidemia on diabetic peripheral neuropathy among patients with type 2 diabetes mellitus.

Patients and methods

A total of 60 patients with peripheral diabetic polyneuropathy were included and divided into two groups: the first included 30 patients with diabetic neuropathy and dyslipidemia and the other 30 patients had diabetic neuropathy without dyslipidemia. Another 30 healthy volunteers were included as a control group. All were subjected to full history taking, clinical examination, laboratory investigations, and neurophysiological studies.

Results

Hypertension and smoking were significantly increased in cases when compared with controls. Regarding the severity of neuropathy, it was mild in seven (11.7%) patients, moderate in 34 (56.7%) patients, and severe in 19 (31.7%) patients. Neurophysiological studies of the studied populations revealed significant changes of both motor and sensory parameters in cases when compared with controls and in the group with dyslipidemia when compared with the group without dyslipidemia. In addition, there was a significant correlation between lipid profile and each of glycated hemoglobin, fasting and postprandial blood sugar, and different neurophysiological examinations.

Conclusion

Dyslipidemia added to the hazardous effect of diabetic neuropathy on neurophysiological studies. In addition, there was a significant correlation between lipid profile and changes in nerve conduction studies.
Psychological changes of a sample of morbid obese patients before and after bariatric surgery
Authors: Hammouda Safaa M. , Elaziz Shaimaa Y.A. , El-Rahman Abo Sena Kamal A.
Published: April 2024

Objective

Morbid obesity (defined as a BMI>40) is a severe condition in developing countries. Morbid obese patients are at high risk for psychiatric and psychological dysfunctional disorders. Moreover, many of bariatric surgery candidates experience mood disorders, anxiety, and eating disorders after bariatric surgery.

Patients and methods

Psychological assessment was done using the Arabic version of structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition axis I disorders for 70 morbid obese patients (22 males and 48 females), with mean age of 36.57 years, at Al-Zahraa University Hospital, before they underwent bariatric surgery. Psychiatric reassessment for the same patients was done 6 months later after the operation.

Results

The prevalence of psychiatric disorders among 70 morbid obesity participants who underwent obesity surgery was 48.6%, depression was 45.71%, anxiety was 12.86%, and eating disorders (binge eating) was 11.43% before surgery, whereas reassessment 6 months after surgery by reusing Arabic version of structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition axis I disorders showed decrease in psychiatric disorders by 20.6%, decrease in diagnosis of depression by 37.5%, and eating disorders, especially binge eating, by 62.5%, but no difference in anxiety.

Conclusion

The results highlight the importance of psychological assessment and counseling before and after bariatric surgery to help patients to achieve their goal of losing weight and improve their quality of life after surgery.
Assessment of sexual dysfunctions among newly married couples in Egypt
Authors: Mohamed Mohamed Essam El-Den , Abdel-Aleem Hazem L. , Hamdy Ahmed G.
Published: April 2024

Background and Aim

Unconsummated marriage is a problem among couples who are not able to perform natural sexual intercourse. The aim of this work was to define the etiological factors of unconsummated marriage in newly married men.

Patients and methods

This is a case–control study that was carried out on 200 newly married men during the period between October 2019 and October 2020, comprising 100 men with sexual dysfunctions leading to unconsummated marriage as a case group and 100 men without any sexual dysfunctions having successful intercourse as a control group. They were evaluated through history taking, psychosexual questionnaires, general and local examinations, laboratory investigations (estimations of serum serum total and free testosterone, estradiol, prolactin, luteinizing hormone, follicle-stimulating hormone, fasting and postprandial blood glucose levels, and lipid profile), and penile duplex.

Results

Regarding sexual history, male c ause of unconsummated marriage was present in 82% of the patients in the form of erectile dysfunction (73% psychogenic and 9% organic, using penile dupplex), and the other 18% of the patients had history of female cause in the form of vaginismus. Psychosexual history showed that history of consulting scientific informative source concerning sexuality was present in only 3% of patients, history of refusing to look closely at the partner's genitalia was present in 4%, and history of being afraid of feeling pain during penetration was present in 9%.

Conclusion

Psychogenic erectile dysfunction was the most common etiological factor for unconsummated marriage. Vaginismus was found to be a major concern regarding unconsummated marriage as well. Lack of scientific information about sexuality was found to be a major risk factor for unconsummated marriage in newly married men.
The outcomes of tubularized incised plate hypospadias repair and tubularized incised plate grafting using muccal mucosal graft and preputial free graft
Authors: Mohammed Abdelnaser H. , Altramsy Ayman , Matar Adel , Elbakry Adel
Published: April 2024

Objective

Hypospadias is the most common anomaly of congenital urogenital defects. Tubularized incised plate (TIP) repair is an established technique. High rates of its complication advocate the idea of grafting of TIP incision. Grafts may be buccal mucosa or prepuce in this study.

Patients and methods

This prospective study included 64 patients complaining of mid and distal penile hypospadias. The patients were randomized into three groups according to the technique used in the repair of hypospadias. The first group included patients repaired by TIP urethroplasty, whereas group B and group C included patients repaired by inner perpetual skin and buccal mucosa, respectively. Follow-up was for 6 months.

Results

This study included 64 cases. TIP repair (group A) was done for 20 patients, whereas in 44 cases, TIP grafting was performed; groups B and C included 21 and 23 cases, respectively. The TIP urethroplasty was successful in 85%, whereas in groups B and C, the success rates were 91.5 and 87%, respectively. There were statistically insignificant differences in complications among all groups (P>0.005).

Conclusion

Outcomes of TIP grafts have no significant difference than outcomes of TIP technique.
Panniculectomy during cesarean delivery
Authors: Abdelaty Walid R. , Taha Wael S.
Published: April 2024

Background

Panniculectomy has frequently been asked by many women to be done in the same session as a cesarean section (CS), to remove excess skin and stretch marks that develop during pregnancy and gain the benefits from avoiding a future surgery and repeated anesthesia.

Aim

To evaluate the safety, the cosmetic results, and possible complications of combining panniculectomy with CS.

Patients and methods

This study included 50 pregnant women who underwent panniculectomy combined with CS. The study was conducted in Al-Hussain University Hospital, in Cairo, Egypt, during the period from April 2018 till February 2020, and had an average follow-up period of 6 months.

Results

This study showed that 24 (48%) patients were happy with the overall results. More than 50% of the cases had either postoperative complications or some unpleasant results. Persistent bulging of the abdomen and/or lack of waist definition (36%) were the most unesthetic result. Postoperative complications included infection (18%), wound dehiscence (9%), and distal skin necrosis (12%).

Conclusion

It may seem quite beneficial to combine the two surgical procedures in the same setting. However, owing to the higher risk of postoperative complications and unesthetic outcomes, it does not seem to be in the best interests of most patients.
Role of conventional magnetic resonance imaging and diffusion-weighted imaging in evaluation of breast lesions
Authors: Abdel-Raheem Mohammed Abdel-Fattah , Abdel-Samiae Hoda Abdel-Kareem , Ahmed Yasser Abdel-Aal , Sleem Moutaz Mahmoud
Published: April 2024

Background and Aim

This study aimed to evaluate the role of diffusion-weighted imaging (DWI) and apparent diffusion coefficient in diagnosis of the breast lesions.

Patients and methods

This study included 100 patients referred to the Radiology Department of Al-Azhar Assiut University Hospital from February 2018 to May 2020 for DWI MRI examination with a provisional diagnosis of breast lesions. All patients were recruited after meeting the inclusion criteria. They underwent clinical examination, mammography, ultrasonography, and contrast-enhanced MRI with DWI.

Results

Our study included 100 cases. The combined MRI protocol of dynamic contrast-enhanced (DCE)-MRI and DWI was true positive in 60 and true negative in 30 patients. The combined MRI protocol of DCE-MRI and DWI provided a sensitivity of 92%, a specificity of 90%, a positive predictive value of 95.8%, a negative predictive value of 81.8% and accuracy of 91.43%. In this study, the addition of DWI to standard DCE-MRI provided a 10% increase in the specificity of breast MRI, with a 4% decrease in the sensitivity.

Conclusion

DWI is a short unenhanced scan and had the highest specificity compared with other imaging modalities, as it reduced the false-positive results. It should be added to conventional breast MRI to increase the sensitivity and specificity of MRI.
Chronic ethanol and tramadol interaction on the testicular tissues in adult male Albino rats
Authors: Gad Allaha Ahmed M. , Hemeda Mohamed S.
Published: April 2024

Background and aim

In the developing and advanced countries across the world, young people have the tendency of consuming alcohol in combination with other abused substances. This study aimed to investigate the biochemical and histopathological effects of chronic toxic effects of two commonly abused substances, ethanol and/or tramadol, on testicular function in adult male Albino rats.

Materials and methods

Forty animals were equally divided into four groups: control group that received normal saline only, ethanol group that received ethanol [30% (v/v)] orally at a dose of 2 g/kg, tramadol group that received tramadol subcutaneously at a dose of 60 mg/kg, and ethanol+tramadol group that received ethanol+tramadol by the route and at the dose described above for 60 days. Twenty-four hours after the administration of the last dose, rats were sacrificed, blood samples were obtained, and serum testosterone was determined. Testes were harvested and weighed. Glutathione, superoxide dismutase, catalase, glutathione peroxidase, and malondialdehyde levels and histology (hematoxylin and eosin) were evaluated in the testis.

Results

Testosterone level, relative testicular weights, and testicular glutathione, catalase, superoxide dismutase, and glutathione peroxidase were significantly reduced in all experimental groups compared with controls. Conversely, malondialdehyde was significantly increased in all experimental groups compared with controls. Testicular histology in ethanol and/or tramadol showed structural aberrations that are consistent with antioxidant depletion and oxidative stress.

Conclusion

Abuse of ethanol and/or tramadol exerted similar, additive, and synergistic, adversely affected the male-reproductive functions, which may be due to the effects on the antioxidant-defense system and caused oxidative tissue injury as well as testicular structural aberrations.