bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Profile of Blood Culture-proven Typhoid and Paratyphoid Fever in Hospitalized Patients from a Tertiary Care Hospital in South India
Authors: Kandikuppa Ravi Teja , Gopalakrishnan Ram , Ramasubramanian Venkatasubramanian , Krishna Vidya , Nambi Panchatcharam Senthur , Sethuraman Nandini 
Published: December 2024

Introduction:
Enteric fever is an important cause of community-acquired sub-acute febrile illness, particularly in India. Over the years, improved availability of blood cultures has helped increase the number of cases diagnosed and receive appropriate treatment.

Materials and Methods:
A retrospective observational study on the clinical profile of hospitalized blood culture-proven enteric fever patients from October 2018 to March 2023 was done.

Results:
Of 125 patients, 68 (54.4%) had an infection with Salmonella typhi, and 57 patients (45.6%) with Salmonella paratyphi A. 69 (55.2%) had fever for 1–3-week duration. Among the 55 children, 32 (58.1%) had infection with S. paratyphi A and 23 (41.81%) with S. typhi. There were no life-threatening complications such as intestinal hemorrhage, perforation, or death. Seventy-seven (61.6%) of patients received ceftriaxone and azithromycin combination antibiotic therapy. Fluoroquinolone resistance was present in all the isolates (100%). Sixteen patients (12.8%) received inappropriate antibiotics before admission. Absolute eosinopenia (0%–1%) was seen in 102 (81.6%). The overall mean time to defervescence (TTD) in the study was 3.7 ± 1.3 days. The TTD was 0.7 days longer in patients presenting with fever for <7 days compared with patients with a fever of 1–3-week duration, with a statistically significant P = 0.012.

Conclusions:
Sending appropriate blood cultures, avoidance of inappropriate empiric antibiotic therapy, using combination antibiotic therapy, and a vaccine that protects against both S. typhi and paratyphi serotypes are some of the essential steps in reducing the burden of enteric fever.
Clinical and laboratory profile and its outcome in scrub typhus-positive acute febrile illness cases in the Pediatric Department of BRD Medical College, Gorakhpur
Authors: Chaudhary Anamika , Sharma Bhoopendra , Pandey Ashok Kumar , Singh Priyanka 
Published: December 2024

Background:
A common cause of acute febrile illness in India is scrub typhus, a zoonosis caused by Orientia tsutsugamushi. It is a reemerging cause of acute undifferentiated fever in India and around the world. It was previously thought to be a seasonal disease occurring mainly in rural areas, but cases are now frequently detected in urban areas outside the monsoon season. This study determined the prevalence of scrub typhus and investigated the clinical and laboratory characteristics of scrub typhus-positive AFI cases and their outcomes.

Material and Methods:
The hospital based cross-sectional study included rapid tests for malaria parasites, scrub typhus immunoglobulin M (IgM) (enzyme-linked immunosorbent assay), typhoid IgM, and dengue IgM. Patients underwent the required investigations, such as cerebrospinal fluid examination.

Results:
Seventy-two (37.1%) of the 194 AFI patients were scrub typhus positive. The male-to-female ratio was 0.8:1. The most common symptom among the 72 scrub typhus-positive AFI patients was loose stools (61.1%), followed by vomiting (59.7%), abdominal pain (52.8%), headache (30.6%), swelling (13.9%), cramps (13.9%), and rash (11.1%). About 69.7% of rural land is scrub typhus positive. Fifty-four (75.0%) patients had thrombocytopenia, whereas hyperbilirubinemia was noted in 7 (9.7%) cases. Impaired renal function was noted in 9 (12.5%) cases. Hypocalcemia was reported in 25 (36.7%) patients, hyponatremia in 40 (55.6%) cases, and hypokalemia in 2 (2.8%) cases.

Conclusion:
Scrub typhus is common, accounting for a third of AFI cases. It is more common in rural and female-dominated areas. A child admitted with AFI with hepatosplenomegaly, lymphadenopathy, and anemia with thrombocytopenia must be evaluated for scrub typhus.
A Survey and Comparison the Amount of Important Pollutants in the Exhaust of Light Gasoline Vehicles Referring to the Technical Inspection Centers in Urban Areas: A Case Study in Iran
Authors: Khodabakhshi Abbas , Alijanvand Moluk Hadi , Mohammadi-Moghadam Fazel , Mutauligalleh kolaie Abdullah , Ebrahimi Soghra 
Published: December 2024

Abstract

Aims:
Traffic congestion and the increase in the number of vehicles lead to an increase in vehicle emissions, consequently causing, a decrease in ambient air quality. The objective of this study is to investigate and compare the concentrations of exhaust gases, namely carbon dioxide (CO2), carbon monoxide (CO), hydrocarbon (HC), and oxygen (O2), emitted by cars tested at the Technical Inspection Centers in Shahrekord and Rasht.

Methods:
In this cross-sectional study, primary data from 82,316 cars examined at the technical centers in Shahrekord and Rasht were collected and subjected to statistical analysis. The car frequencies considered were 1000 and above. Overall, 16 types of Iranian and foreign cars were assessed, with 51,919 cars from Rasht and 30,397 cars from Shahrekord. The statistical analysis employed a six-way multivariate analysis of variance.

Results:
The proportion of carbureted cars that were rejected exceeded that of injection cars, while the percentage of cars rejected due to CO2 emissions was lower than that of authorized cars (P < 0.05). Furthermore, the likelihood of these associations occurring in Shahrekord city was higher than in Rasht city, with a chance ratio and confidence interval (CI) of 95. The odds ratios (ORs) (95% CI) were 1.936 (1.829–2.050) and 3.036 (2.924–3.151), respectively. Moreover, the rejection rates were higher (P < 0.05) for cars manufactured in Iran compared to foreign-made cars, private vehicles compared to public vehicles, and cars with CO pollution compared to licensed cars. The likelihood of these associations transpiring in Shahrekord city, in comparison to Rasht city, were as follows: OR (95% CI) of 0.793 (0.755–0.834), 0.667 (0.743–0.598), and 0.018 (0.016–0.020), respectively. The audit analysis, which involved a linear combination of O2, CO, CO2, HC, and vehicle age, successfully differentiated between cars in Shahrekord and Rasht, yielding a correct prediction rate of 81.3% (Wilks’ Lambda statistic = 0.687, Eigen value = 0.455, Canonical correlation value = 0.60 with a P < 0.0001).

Conclusion:
The findings of this study offer a practical approach to address the complexities arising from the emission of polluting gases, contributing to the global warming phenomenon.
Descriptive study of patient outcome and satisfaction with telemedicine and physical consultation during and after the COVID-19 pandemic
Authors: Asodariya Ronak , Bhatnagar Kavita R , Jaisingh Kirti , Tandon Manjari , Pandey Latika , Agrawal Nikhil , Misra Sanjeev 
Published: December 2024

Purpose:
This study was conducted to assess patients’ outcome and satisfaction with the eye care received with telemedicine and physical consultation at a tertiary care hospital during and after the coronavirus disease 2019 (COVID-19) pandemic.

Methods:
A descriptive study was carried out on 6052 patients who consulted for eye illness at a tertiary care hospital between April 2020 and December 2022. An outcome scoring system was developed and validated for the assessment of patient outcome after providing treatment on telemedicine consultation and physical consultation. Outcome scores for various symptoms were compared pretreatment and posttreatment. Telehealth Usability Questionnaire (TUQ) was used through an online survey to assess patients’ satisfaction with teleophthalmology services during the COVID-19 pandemic. An 18-item Patient Satisfaction Questionnaire (PSQ-18) was used to assess the same with physical consultation.

Results:
A total of 6052 patients were included in the study. Physical consultation group had 2485 patients (41.06%) and the telemedicine group had 3567 patients (58.93%). Male patients constituted 63.11% and females were 36.89%. There was a significant improvement in outcome scores for pain and redness in both physical and telemedicine consultation groups (P < 0.0001). All subgroups of TUQ had significantly high scores (including usefulness, ease of use and learnability, interface quality, interaction quality, and satisfaction and future use), except one subgroup (reliability). Uneducated patients were significantly more satisfied with telemedicine compared to educated patients (P = 0.044).

Conclusion:
Majority of patients expressed satisfaction with teleophthalmology services. The recent pandemic paved the way for the future integration of telemedicine in ophthalmology, especially if virtual eye examinations attain a higher level of reliability.
Papillon-Lefevre syndrome: Case series
Authors: Patel Vasumati I. , Thakkar Karan R. , Gupta Shalini S. , Pujara Meghna J. 
Published: December 2024

Abstract
Papillon-Lefevre syndrome (PLS) is an exceptional autosomal recessive disorder characterized by palmoplantar keratinization and premature loss of deciduous and permanent teeth. The palmoplantar keratoderma commonly has its onset between the ages of 1 and 4 years with severe periodontitis initiating at 3 or 4 years old. Parental consanguinity has been demonstrated in 20% to 40% of the cases. Management and preservation of teeth in such patients is a challenge to periodontists. Genetic studies have shown that mutation in the major gene locus of chromosome 11q14.1–q14.3 with the loss of function of the Cathepsin-C (CTSC) gene is responsible for PLS. An early diagnosis of the syndrome can help preserve the teeth through early institution of treatment, using a multidisciplinary approach. We hereby present four cases having all the characteristic features of the syndrome.
A case of dermatofibrosarcoma protuberance with myoid differentiation – A rare occurrence
Authors: Shetty Nisha , Sharma Swati , Kudva Adarsh 
Published: December 2024

Abstract
Dermatofibrosarcoma protuberans (DFSP) of the head and neck is a rare, locally infiltrative, low-grade sarcoma that typically involves the dermis and surrounding structures occurring in middle-aged adults. The common clinical presentation consists of a slowly enlarging, indurated plaque, usually asymptomatic, found on the trunk. In this case report, we present a case of a 37-year-old male patient with facial swelling which was diagnosed as classic DFSP along with myoid differentiation, which is a rare occurrence. Here, we have discussed the clinicopathologic features and histogenesis that can aid in the diagnosis and treatment of this condition.
Malignant fibrous histiocytoma of the mandible: A rare case report with diagnostic challenge and treatment approach
Authors: Sharma Preethi N. , Chaudhary Minal S. , Hande Alka H. , Patil Swati K. 
Published: December 2024

Abstract
Malignant fibrous histiocytoma (MFH), now termed undifferentiated pleomorphic sarcoma (UPS), is a high-grade tumour, mostly affecting the extremities and retroperitoneum. It is a rare entity in the mandible. After a literature search in the PubMed database, only 15 cases have been reported, indicating how uncommon it is in the mandible. In this instance, we document an unusual occurrence of MFH, affecting the mandible in a 37-year-old male patient. Histopathology of the biopsy specimen along with the strong positivity to immunohistochemical markers such as Vimentin and CD68 confirmed the diagnosis of MFH. It is a rare entity presenting diagnostic and therapeutic challenges requiring a multidisciplinary approach for optimal management and treatment.
Association between alcohol consumption and sleep difficulty in a nationwide Korean survey
Authors: Hwang In Cheol , Park Yujin , Ahn Hong Yup , Kim Kwan Jung , Park So-Jung 
Published: December 2024

Abstract

Background:
The data on the association between alcohol intake and sleep quality in a community-based setting are lacking. This study examined overall sleep difficulty according to alcohol habits among Korean adults.

Materials and Methods:
We analyzed data from 4937 adults who responded to questions about sleep difficulty and drinking habits from the 2019 Korea National Health and Nutrition Examination Survey. Multivariate logistic regression analyses were used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for substantial sleep difficulty based on the frequency or amount of alcohol consumption in total and age- and sex-stratified subgroup analyses.

Results:
Approximately 8.5% of the study population had substantial sleep difficulty. Individuals who drank <1 per week (frequency) or 1–2 cups per time (amount) had the lowest prevalence of substantial sleep difficulty, even compared with nondrinkers. Among drinkers, the association between alcohol use and sleep difficulty was significant in a dose-dependent manner (P for trend: 0.003 in frequency and < 0.001 in amount). Subgroup analysis revealed that significant linear relationships were robust for adults aged <50 years ([ORs] 1.20 [95% CIs 1.03–1.40] for frequency and 1.25 [1.10–1.42] for amount) and females (1.26 [1.10–1.44] for amount).

Conclusion:
Alcohol consumption is associated with increased sleep difficulties, especially in younger adults and women, underscoring the need for targeted interventions and in-depth research on the effects of alcohol on sleep.
Psoriasis and malignancy, is there a link? Data from the Malaysian Psoriasis Registry
Authors: Mashor Mazliha , Chan Gin Peng , Robinson Suganthy , Tang Min Moon 
Published: December 2024

Abstract

Background:
The risk of malignancy in psoriasis patients may be attributed to the chronic inflammatory course of the disease, the associated comorbidities and the treatment modalities employed. However, the association between psoriasis and malignancy has not been explored among Asians in depth. Our aim is to determine the frequency of malignancy and to identify the risk factors associated with malignancy among psoriasis patients in Malaysia.

Materials and Methods:
A retrospective cross-sectional study utilising the database of the Malaysian Psoriasis Registry was conducted. All psoriasis patients registered from 1 January 2007 to 31 December 2018 who were diagnosed with malignancy during their lifetime were included.

Results:
There were 123 (0.57%) psoriasis patients who reported a malignancy from a total of 21,735 patients. The male-to-female ratio was 1:1.41. The rate of malignancy was highest among inverse psoriasis (4.81%) patients followed by localised pustular psoriasis (1.79%), guttate psoriasis (0.81%), plaque psoriasis (0.57%) and erythrodermic psoriasis (0.26%). The ethnic Chinese had the highest rate of malignancy (32.5%) followed by Malays (31.7%) and Indians (14.6%). The top five cancers reported among our psoriasis patients were breast cancer, haematological cancers, colorectal cancer, female genital cancers and brain cancers. Only 1 paediatric patient (16 years old) had malignancy which was a brain tumour.

Conclusions:
The frequency of malignancy was 0.57% among psoriasis patients in our registry. Being older than 40 years and female were significantly associated with malignancy in psoriasis patients. The rate of malignancy was highest among inverse psoriasis patients.
Prevalence of dry eye disease in rheumatoid arthritis patients and its correlation with duration of rheumatoid arthritis
Authors: Gandhi Priyanshi Ashishbhai , Samar Arun Kumar , Kathuria Nitish , Mishra Avinash , Chhabra Harbeer Singh 
Published: December 2024

Abstract

Background:
Dry eye is a condition of the tear film and ocular surface that causes discomfort, visual disturbance, and tear film instability. The subjective symptoms in dry eye disease (DED) are often nonspecific. More or less common are conjunctival redness and damage to the ocular surface with punctate epithelial erosions. Rheumatoid arthritis (RA) is a systemic autoimmune disease with approximately 25% of patients having ocular manifestations.

Methodology:
A prospective observational study was carried out in the ophthalmology outpatient department of a tertiary care center. There were 200 RA patients enrolled. Dry eye workup was done using various tests and the Ocular Surface Disease Index questionnaire. RA patients were divided on the basis of duration of illness into two groups. The results of dry eye tests were compared between these two groups.

Results:
Out of 200 RA patients, 89% were females. The overall prevalence of dry eye was 52.5% according to Schirmer’s test without anesthesia. There were 112 patients who were suffering from RA for <5 years and another group of 88 patients who were suffering for ≥5 years. Schirmer’s test and corneal fluorescein staining suggested that the patients with longer duration of RA are more prone to DED.

Conclusion:
The prevalence of dry eyes in patients with RA is high. Chronic ocular surface changes were observed with the longer duration of RA disease activity which affects the quality of life in such patients.
Development and Validation of a Filipino Version of Obstetric Quality of Recovery-10
Authors: Carandang Rafael Jacob T. , Pablo Ma. Carmela B. , Bonus Guada Marie M. , Quintin Ma. Patricia Mae J. , Guo Nan , Sultan Pervez 
Published: December 2024

ABSTRACT

Background:
The Obstetric Quality of Recovery-10 (ObsQoR-10) is a patient-reported outcome measure that provides a holistic assessment on the quality of in-hospital postpartum functional recovery. Validated across several countries in various languages, it has shown great potential for widespread global acceptance in both clinical practice and research. We aimed to develop a Filipino version of the ObsQoR-10 and to evaluate its validity, reliability, and feasibility.

Methods:
One hundred women who had elective cesarean delivery (CD) completed the ObsQoR-10-Filipino and EuroQol five-dimensional 3 L Filipino version questionnaires (including a Global Health Visual Analog Scale [GHVAS]) 24 h after delivery. Twenty-five women completed the ObsQoR-10-Filipino survey again 25 h after delivery. Validity was assessed by evaluation of convergent validity, discriminant validity, and hypothesis testing. Reliability was assessed by evaluating internal consistency, split-half reliability, and test–retest reliability; and (iv) floor and ceiling effects.

Results:
The ObsQoR-10-Filipino scores showed good and moderate correlation to the EQ-5D-3 L scores (r = −0.636; 95% confidence interval [CI]: −0.740–−0.503, P < 0.001) and to the GHVAS scores (r = 0.387; 95% CI: 0.207–0.543, P < 0.001), respectively. ObsQoR-10-Filipino discriminated well between good (GHVAS score ≥ 70, 68.4 ± 12.9) and poor recovery (GHVAS score < 70, 55.1 + 12.9). Internal consistency was acceptable (Cronbach’s α =0.76), and split-half reliability was very good (Spearman–Brown Prophesy Reliability Estimate = 0.87). Test–retest reliability was excellent (intraclass correlation coefficient = 0.973; 95% CI: 0.873–0.976). No floor or ceiling effects were observed. The recruitment rate and completion rate were 92% and 91%, respectively. No correlation was observed between the ObsQoR-10-Filipino scores and factors such as maternal age, gestational age, blood loss, and American Society of Anesthesiologists classification.

Conclusion:
The ObsQoR-10-Filipino is a valid, reliable, and feasible tool for assessing inatient postpartum recovery in Filipino-speaking women undergoing elective CD.
Efficiency of Packed Red Cell Utilization and Establishment of Effective Maximum Surgical Blood Order Schedule in Elective Coronary Artery Bypass Graft Surgery in a Specialized Tertiary Care Center
Authors: Rayos Del Sol Joanna Marie Dalisay 
Published: December 2024

ABSTRACT

Background:
Implementation of blood conservation protocol may increase the efficiency of blood utilization and optimize the maximum surgical blood ordering schedule (MSBOS) in our institution. The primary objectives of this study are to evaluate the efficient utilization of a fixed blood request of 4 units of packed red blood cells (PRBCs) and to establish an effective MSBOS on primary isolated elective coronary artery bypass graft (CABG).

Methodology:
This was a retrospective, analytical, observational, cohort type of study conducted through chart review of CABG patients from January 2018 to December 2019. Indices used to evaluate blood utilization efficiency were crossmatch to transfusion (C/T) ratio, transfusion probability (T%), and transfusion index (TI). MSBOS was computed based on the data gathered.

Results:
A total of 77 patients were included in this study. Blood transfusion based on C/T ratio was associated with body surface area <1.75 m2 (P = 0.006) and involvement of distal grafts >3 vessels (P = 0.042). Overall, C/T ratio was 2.44, T% was 70.1%, and TI was 1.69. Unutilized blood was measured at 59%. The computed MSBOS for elective CABG was at 2 units (2.53).

Conclusion:
There is efficient PRBC utilization in primary elective CABG when the blood indices were used. Evidence-based MSBOS is established and the previous 4 units PRBC can be reduced to 2 units to promote C/T ratio <2 as evidence of an optimal blood utilization.
Multiple Fractures with Bony Deformities: An Unusual Clinical Presentation of Distal Renal Tubular Acidosis
Authors: Karthika I. K. , Kavati Hemanth , Satapathy Amit Kumar 
Published: December 2024

Abstract
Renal tubular acidosis (RTA) is characterized by hyperchloremic metabolic acidosis resulting from defective urinary acidification. Though rickets with bony deformity is a common manifestation in proximal RTA, it is rarely seen in children with distal RTA. We are reporting three cases of distal RTA who presented with multiple fractures of bones and had radiological evidence of rickets. All three children had normal anion gap metabolic acidosis with hypercalciuria. Ultrasound revealed medullary nephrocalcinosis in all three children. All of them had shown improvement following bicarbonate therapy and potassium supplements. Early diagnosis not only helps prevent complications like fractures but also ensures optimal growth and development.
A Comparative Study of Meropenem Utilization and Clinical Outcomes in Two Hospitals in Saudi Arabia Employing Different Antimicrobial Stewardship Strategies
Authors: Alzayer Reem , Thabit Abrar K. , Almohanna Hani , Al-Mahasnah Reem , Aljuzair Zahrah , Alyaqoub Salma , Aljishi Yamama , AlBassam Hamad 
Published: December 2024

Abstract

Background:
Effective antimicrobial stewardship (AMS) programs are crucial for managing infectious diseases and reducing antimicrobial resistance. Recent efforts in Saudi Arabia have demonstrated progress in reducing broad-spectrum antibiotic use through these programs. This study aims to compare two antimicrobial stewardship strategies implemented in Saudi hospitals to evaluate their impact on meropenem use and patient clinical outcomes.

Materials and Methods:
A retrospective study analyzed data of patients hospitalized from 2020 to 2023 at two Saudi hospitals: King Fahad Specialist Hospital (Hospital A) with 9012 admissions and King Abdulaziz University Hospital (Hospital B) with 56,765 admissions. Endpoints included meropenem use (defined daily dose and days of therapy [DOT] per 100-patient days), mortality rates, and length of stay. Statistical analyses, including chi-square, Fisher’s exact, Mann–Whitney U tests, and regression, were conducted using SPSS version 24 (IBM Corp., Armonk, NY, USA).

Results:
The study involved 226 patients: 134 from Hospital A and 92 from Hospital B. Hospital B had older patients and more cases of urinary tract infections, while Hospital A had more cases of polymicrobial cultures and higher meropenem use. Hospital A implemented higher meropenem doses and longer duration of therapy. Mortality rates were similar, but Hospital A had a longer length of stay (19 days vs. 12 days).

Conclusion:
The study showed substantial variations in meropenem use between two hospitals, highlighting the importance of focus on antibiotic stewardship. Further research should be conducted to investigate these variances and their impact on patient clinical outcomes.