bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management and outcomes of ureteroceles in children
Authors: Jain Vishesh , Agarwala Sandeep , Dhua Anjan , Mitra Aparajita , Mittal Deepak , Murali Divya , Kandasamy Devasenathipathy , Kumar Rakesh , Bhatnagar Veereshwar 
Published: April 2021

Introduction:
Ureterocele is a rare urogenital malformation. The treatment is variable and complicated as it depends on several factors. The aim of this study was to evaluate the management and outcomes of children with ureterocele and to compare single system and duplex system ureteroceles.

Materials and Methods:
A retrospective study was conducted and all patients with ureterocele operated from January 1992 to December 2018 were included. The records of those included were assessed, and a detailed case record sheet was filled. The outcome parameters assessed were the persistence of symptoms and additional surgical procedure performed.

Results:
Forty-seven patients (28 boys and 19 girls) with a median age of presentation of 21 months were included. Four patients had bilateral ureterocele. Overall, 51 renal units with ureterocele were studied. Twenty renal units of the 31 renal units with duplex system underwent cystoscopic decompression, and of these, 8 (40%) needed a second procedure. Fourteen renal units of the remaining 20 renal units with single system underwent cystoscopy and decompression, and of these, 1 (7%) required another procedure (P = 0.024). Sixteen renal units had ectopic ureterocele, of which 9 (56%) underwent heminephrectomy/nephrectomy. Intravesical ureterocele was present in 35 renal units, of which only 2 (5.7%) underwent nephrectomy or heminephrectomy (P < 0.001).

Conclusion:
Duplex system ureteroceles are more likely to require a second procedure following an endoscopic puncture. Units with ectopic ureterocele were more likely to need nephrectomy.
Challenges and difficulties in research facing by Saudi board postgraduate residents in Aseer region
Authors: Alhefzi Amal Abdulkhalig , Alsaleem Safar A. , Al Humayed Razan Suliman , Al Khathami Mohamme Ali Mosfer , Ali Alwalan Ali Ahmed , Saaed Al Mufarrih Wael Saad , Mohammed Alqarni Mohammed Awadh , Khalawy Mokali Bassam Mousa , Maghram Assiri Bassam Mohammad 
Published: April 2021

Introduction:
Research in health care system plays an important role in advancement and development of medicine and is essential in identifying the most optimal management. Progression in medicine depends upon the training and performance of researchers in health science. Training in research activity is an important aspect of post graduate training and has been recognized as one of its key components. It enhances learning and critical thinking of the resident.

Methods:
A purposely constructed questionnaire was used to gather the data, questionnaire was composed on demographic items, items related to the problems/difficulties regarding research, items related to specialty selection. Questionnaire was composed of by the panel of experts including subject (research faculty of the college) specialist, English language expert, family physician.

Results:
Mean ± S.D of age = 29.2 ± 8.6. 62.0% of the respondents were belongs to the age group of 25-30 years old, 22.% belongs to the 31-35 years old. 44.1% were female while 55.9% were male. Only 13.0% of the respondents finished the residency program (17.1% in R1, 25.7% in R2, 21.6% in R3, 13.6% in R4 while 2.5% in R5 and 6.7% as an adhoc). 51.6% have experience of healthcare from 1 to 3 years. 31.3% respondents participated in the research as a co-author while 26.3% participated in a research as principal investigator.

Conclusion:
To conclude, it is necessary to guide the students to conduct studies and keep them motivated. It is also important to reward them so keep their interest intact in research. In this view involving students in research committee and providing them a platform for presentation are very good methods to keep them motivated.
The impact of the English medical curriculum on medical history taking from Arabic speaking patients by medical students
Authors: Alnahdi Muhannad A , Alhaider Abdullah , Bahanan Fahad , Aldubaikhi Ahmed , Aljehani Abdulrahman , Omair Aamir , Alaqeel Meshal 
Published: April 2021

Introduction:
Medical education in Saudi medical colleges is delivered to students through a completely English language curriculum, whereas the practice that students face in the hospital is generally conducted in Arabic language settings. We suggest that the linguistic gap between the adopted medical curriculum and actual practice could influence students' confidence and level of difficulty in history taking in Arabic. The study aimed to identify the effects of learning history taking in the English language on applying it in the medical student's native language.

Methods:
This cross-sectional design study was held in the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS). The targeted sample size was 377 medical students from the fourth to the sixth year, and stratified random sampling was used. The questionnaire used was self-developed, validated, and pilot tested in other medical colleges. The questionnaire asked about students' confidence, the difficulty of Arabic history taking, and suggested strategies to improve the current curriculum.

Results:
The response rate was 290 participants (76.9%), males were 205 (71%), and 136 (47%) were in the fourth year. Agreement on feeling confident while taking history taking in Arabic was 98 (33.8%), 102 (35.2%) were neutral, and 90 (31%) disagreed. Moreover, 138 (47.6%) of students preferred training for Objective Structured Clinical Examination (OSCE) in Arabic more than English, 86 (29.7%) were neutral, while 66 (22.8%) disagreed. The mean level of difficulty was 2.1 ± 0.7 (range 1- 5). Additionally, 198 (68%) of students suggested adding short Arabic history courses.

Conclusion:
Students considered history taking in Arabic as easy, even though they were not completely confident. Further efforts are needed to uplift students' of confidence to optimal levels.

Advances in Knowledge:
Communication is the cornerstone of medical education as well as clinical practice. The study explores the impact of instruction language on the physician-patient communication dynamic, providing better infrastructure for evidence-based educational practice.

Application to Patient Care:
This study gives insight into the students' level of preparation to practice in their local community and language. Furthermore, the study addresses strategies to enhance students communication skills and alleviate linguistic barriers in the physician-patient encounter.
Gliomas - An experience based on molecular markers
Authors: Sarma Susmita , Khonglah Yookarin , Mishra Jaya , Kakati Arindom , Phukan Pranjal 
Published: April 2021

Background:
Gliomas account for 45% of all intracranial tumors. Newer technologies have allowed deeper genetic and epigenetic analysis leading to the discovery of IDH (Isocitrate dehydrogenase) mutations and their association with ATRX (alpha-thalassemia/mental retardation syndrome X-linked) and p53, for better diagnosis and prognosis. In this study, we analysed their expression and correlated with various clinicopathological parameters. A follow up to prognosticate gliomas based on the molecular findings is also attempted.

Materials and Method:
During last 5 years both retrospective and prospective cases were included in the study. Immunohistochemistry for IDH1, ATRX, and p53 was done and reported based on intensity and percentage of tumor cells expressing the markers.

Results:
A total of 53 cases of gliomas were included, excluding primary glioblastomas and ependymomas. The patient's age ranged from 10 to 53 years. The male to female ratio was 1.3:1. IDH1 positivity was seen in 88% of diffuse astrocytoma, 80% of anaplastic astrocytoma, 90% of oligodendroglioma, 60% of anaplastic oligodendroglioma, and 54% of glioblastoma. A significant association was seen between positive IDH1 expression and low-grade gliomas (p = 0.028). A combined analysis of expression of IDH1 and ATRX versus IDH1, ATRX, and p53 with WHO grade showed a statistically significant association. A follow-up of 32 patients was available. Out of 24 IDH1+ (positive) cases, 22 patients had a median survival of 21.5 months (92%). Out of 8 IDH1- (negative) cases, 5 had a median survival of 15.8 months (62%).

Conclusion:
Gliomas expressing IDH1 mutation show improved survival of patients. Combined analysis of IDH1, ATRX, and p53 has diagnostic and prognostic significance. For routine cases of gliomas, a combination of IDH1 and ATRX are sufficient; however, the use of p53 is recommended for further prognostication and for possible targeted therapy in the future.
Overview of e-Health initiatives in Rajasthan
Authors: Joshi Nitin Kumar , Bhardwaj Pankaj , Suthar Praveen , Jain Yogesh Kumar , Joshi Vibha , Singh Kuldeep 
Published: April 2021

Background:
Government of Rajasthan has undertaken a series of e-Health initiatives, especially under various programs of National Health Mission in the past few years. There is a paucity of studies which document and provide appraisal of these initiatives in Rajasthan.

Aim:
To document ongoing e-Health Initiatives based on technologies and approaches used, coverage by the region and population, services provided and scope.

Materials and Methods:
Primary data collection in form of key-informant interviews while secondary data collection in form of internet-based search of peer and non-peer reviewed literature was conducted to achieve the study objectives. Appropriate documents, records, and reports were reviewed to ensure that all necessary information was obtained.

Results:
A total of 13 e-Health initiatives were included in the study. The e-Health programs were classified with the use of WHO's classification of Digital Health Interventions v1.0. Most of the initiatives perceived in the study were found to be beneficial to the community, covering the entire population targeted. Supporting agencies, technologies used, and challenges faced during the implementation were identified and documented. Lack of trained manpower, technical and software glitches and deficiency of awareness activities were few obstacles that were found consistent across all user groups.

Conclusions:
The overview from this study augmented the knowledge about further scopes and sustainability of these initiatives. Deploying dedicated professionals may improve the functioning of these initiatives. Since e-Health interventions significantly influence healthcare systems, further scale-up of such studies with appropriate evaluation should be planned to guide policy decisions.
Seroprevalence of anti-SARS-CoV-2 antibodies in Indore, Madhya Pradesh
Authors: Sakalle Salil , Saroshe Satish , Shukla Harish , Mutha Anita , Vaze Ameya , Arora Arpit , Athotra Aditya , Ramaswamy Sudarshan , Jain Arania , Dhuria Meera , Patil Anil D. , Rai Arvind , Garg Suneela , Jain Sudhir K. , Bindal Jyoti , Singh Sujeet K. 
Published: April 2021

Background:
In India, laboratory diagnosis of SARS – CoV-2 infection has been mostly based on real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Studies have shown that Viral titres peak within the first week of symptoms but may decline later hampering RT-PCR-based diagnostic strategies. Exact estimate is difficult under high-risk screening strategy with evidences of having large number of asymptomatic cases. This has prompted a call for adoption of antibody testing as potential source of data.

Materials and Methods:
A cross-sectional study with a sample size of 7000 was conducted for 15 days including all the 85 wards under Indore Municipal Corporation. Stratified Random Sampling was used to collect the samples. Trained teams collected basic sociodemographic information and serum samples which were tested for the presence of specific antibodies to COVID-19 using ICMR-Kavach IgG ELISA kits. The data collected was compiled and analysed using appropriate statistical software.

Results:
Overall weighted seroprevalence of the study population was found to be 7.75%. The prevalence in males and females was comparable (7.91% vs 7.57%). Highest seropositivity (10.04%) was seen among individuals aged more than 60 years. Total number of infections in the population were estimated to be 2,03,160. Overall Case Infection Ratio was found to be 27.43.

Conclusion:
The current seroprevalence study provides information on proportion of the population exposed, but the correlation between presence and absence of antibodies is not a marker of total or partial immunity. It must also be noted that more than 90 percent of the population is still susceptible for COVID-19 infection. Hence, non-pharmaceutical interventions like respiratory hygiene, physical distancing, hand sanitization, usage of personal protective equipment such as masks and implementation of public health measures need to be continued.
Risk factors of placenta previa with maternal and neonatal outcome at Dongola/Sudan
Authors: Salim Nahid A. , Satti Ismail 
Published: April 2021

Background:
Placenta previa is a major cause of hemorrhage affecting 0.4–0.5% of all pregnancy's early detection of cases and senior input will significantly reduce maternal and fetal morbidity and mortality.

Objectives:
The aim of the study is to determine risk factors, fetal and maternal outcome in pregnancy complicated by placenta previa.

Method:
This is descriptive cross-sectional study in women diagnosed with placenta previa at Dongola maternity hospital, Sudan from December 2018 to June 2019.

Results:
There were 3,674 deliveries and 52 cases of placenta previa during the study period with prevalence of 1.4%. The average age of the patients was 34.8 years and most of them were above 35 years (53.8%), and (63.5%) were para 3 and more. Other identified risk factors included previous cesarean section (69.1%), previous uterine evacuation (13.5%), and assisted reproductive technique (5.8%). Maternal complications were hemorrhage needing blood transfusion (40.4%), cesarean hysterectomy (21.2%), and bladder injury (3.8%), but (34.6%) were with good outcome and no maternal death. NICU admission with RDS (25%), prematurity (25%), and death (5.8%) were the fetal complications, while in (44.2%) fetal outcome was good.

Conclusion:
The most identifiable risk factors for placenta previa were previous uterine scars, advanced maternal age, and multiparity. And it is associated with adverse maternal and fetal outcomes.
Autopsy study of spectrum of lung lesions in Tertiary care hospital
Authors: Goswami Parth Rajendragiri , Goswami Alpeshpuri P. , Khandkar Abhijit S. 
Published: April 2021

Background:
Inflammation, Infections, occupational diseases and neoplastic lesions are common in lungs. In Autopsy internal organs including lungs are studied to decide cause of death and figure out prevalence of various lung lesions. So, prophylactic prevention plan can be prepared for prevention of various lung lesions induced mortality and reducing need for invasive biopsy as well.

Aim & objective:
To find out frequency of various lung lesions in relation to age and sex and analyze histopathological spectrum of lung lesions.

Material & Methods:
Non interventional, record based cross sectional, retrospective autopsy study was done on 139 cases of lung autopsy samples at department of pathology of tertiary care hospital, Bhavnagar, Gujarat for 2 years on samples received from January 2016 to January 2018. Lungs were fixed in 10% formalin & processed. Paraffin wax embedding was done & sections stained with H&E stain. Gross and microscopic examination of samples done and diagnosis was done. All findings were recorded and tabulated.

Conclusion:
Pneumonia is most common observed pathological lung lesion in our study which suggest that infections of lungs are common cause for mortality. Therefore, we suggest effective implementation of measures to prevent hospital acquired pneumonia may reduce mortality. Smoking was associated in nearly 70% patients. Autopsy study of such lung lesions can provide vision to plan preventive strategy to reduce mortality due to lung pathology.
Opinion of primary care physicians regarding prescription of generic drugs
Authors: Charan Jaykaran , Saxena Deepak , Chaudhri Mayur , Dutta Siddhartha , Kaur Rimple Jeet , Bhardwaj Pankaj 
Published: April 2021

Background:
Generics are low-cost alternatives of the existing approved branded drugs. The aim of this work was to study knowledge and perception about generic drugs among the doctors practicing in government and private healthcare sectors.

Methods:
A cross-sectional study was conducted with a prevalidated questionnaire. Physicians working in government and private healthcare sectors were asked to fill the survey form after obtaining written informed consent. Descriptive analysis was used.

Results:
Of 240, 11.6% of primary care physicians could identify all the correct statements regarding generic drugs and 57% physicians agreed or strongly agreed that doctors should prescribe only generic drugs. Substandard quality (24.4%) and less effectiveness (35.6%) of generics was cited major reason for low use. Majority (76.1%) believed that patients will accept substitution of branded with generics but 21% either did not or rarely inform patients regarding generics. Only 11.7% considered generics has low efficacy as compared to branded drugs but majority (57.4%) denied the interchangeability of generics. Majority were aware about the Jan Aushadhi scheme (79.3%) and Indian Medical Council Act (Professional conduct, Etiquette and Ethics) (76.8%). For personal use, 45.6% preferred generics. Around 44% agreed/strongly agreed for pharmacist's right to substitute branded drugs with generics but private practicing physicians opted against it.

Conclusion:
Knowledge and acceptance of generic drugs is still low amongst the doctors. Efforts need to be done increase the awareness and acceptability.
Thoracoscopic bilateral dorsal sympathectomy for primary palmo-axillary hyperhidrosis short- and mid-term results
Authors: Puri Harsh Vardhan , Asaf Belal Bin , Bishnoi Sukhram , Pulle Mohan Venkatesh , Sharma Shikha , Kumar Arvind 
Published: April 2021

Background:
Thoracoscopic bilateral dorsal sympathectomy is the standard of care for primary palmo-axillary hyperhidrosis. This study aims at studying the surgical outcomes with special emphasis on the incidence of compensatory hyperhidrosis (CH) after thoracoscopic dorsal sympathectomy. Post-procedural patient satisfaction as well as quality of life was measured and analysed.

Materials and Methods:
This is a retrospective analysis of sixty thoracoscopic dorsal sympathectomy surgeries in thirty patients in a tertiary level thoracic surgery centre over 2 years. Various peri-operative variables were recorded and assessed. Incidence of CH was noted and analysed in relation to patient satisfaction and record was made of quality of life at the time of discharge, at 3 months and 1-year follow-up following surgery.

Results:
We performed sixty video-assisted thoracoscopic sympathectomies in 30 patients. The mean operative time was 44.93 ± 10 min. The mean hospital stay was 1 day. There were no immediate post-procedural complications. All the patients had complete resolution of palmar and axillary hyperhidrosis. Fifty per cent of our patients (15/30) had some degree of CH after surgery. Quality-of-life measurement showed very good satisfaction by 100% at discharge, by 93.3% at 3 months and at 1 year. Those 6.66% of patients were partially satisfied/not satisfied because of the presence of moderate-to-severe CH.

Conclusion:
A significant percentage of the patients with primary palmo-axillary hyperhidrosis will be very satisfied with the procedure at 1 year after surgery despite 50% of them developing CH. Detailed counselling regarding CH in the pre-operative period would minimise the dissatisfaction rate after surgery.
Microbiology of chronic suppurative otitis media at Queen Elizabeth Central Hospital, Blantyre, Malawi: A cross-sectional descriptive study
Authors: Chirwa M , Mulwafu W , Aswani JM , Masinde PW , Mkakosya R , Soko D 
Published: April 2021

Background Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine the local Malawian microbiology in order to guide adequate treatment, avoid complications, and provide records for future reference.Aim The study sought to determine the CSOM-causing microorganisms at Queen Elizabeth Central Hospital in Blantyre, Malawi, and establish their relationship signs and symptoms, and with the demographic pattern of the study.Methods This was a hospital-based cross-sectional descriptive study carried out at the ENT outpatient clinic and the Microbiology Department of Queen Elizabeth Central Hospital.The sample comprised 104 patients with unilateral or bilateral active CSOM, who met the inclusion criteria. All patients were evaluated through a detailed history and clinical examination. Pus samples from draining ears were collected by aspiration with a sterile pipette. The specimens were immediately sent for microbiological analysis. Data were analyzed using SPSS.version 20.Results The study found that Proteus mirabilis, Pseudomonas aeruginosa, and Staphylococcus aureus were the most prevalent aerobic bacteria, while Bacteroides spp. and Peptostreptococcus spp. were the commonest anaerobic bacteria causing CSOM. These CSOM-causing microorganisms were predominant among males aged 18 years and below. Some CSOMcausing microorganisms were—significantly more so than the others—characteristically associated with each of the following clinical features: quantity of pus drainage, mode of onset, otalgia, hearing loss, location of tympanic membrane perforation, and mucosal appearance.
Improving atmospheric path attenuation estimates for radio propagation applications by microwave radiometric profiling
Authors: Alyosef Ayham , Cimini Domenico , Luini Lorenzo , Riva Carlo , Marzano Frank S. , Biscarini Marianna , Milani Luca , Martellucci Antonio , Gentile Sabrina , Nilo Saverio T. , Di Paola Francesco , Alkhateeb Ayman , Romano Filomena 
Published: April 2021

Abstract. Ground-based microwave radiometer (MWR) observations of downwelling brightness temperature
(TB) are commonly used to estimate atmospheric attenuation at relative
transparent channels for radio propagation and telecommunication purposes. The atmospheric
attenuation is derived from TB by inverting the radiative transfer equation with a
priori knowledge of the mean radiating temperature (TMR). TMR is usually
estimated by either time-variant site climatology (e.g., monthly average computed from atmospheric
thermodynamical profiles) or condition-variant estimation from surface meteorological
sensors. However, information on TMR may also be extracted directly from MWR
measurements at channels other than those used to estimate atmospheric attenuation. This paper
proposes a novel approach to estimate TMR in clear and cloudy sky from independent MWR
profiler measurements. A linear regression algorithm is trained with a simulated dataset obtained
by processing 1 year of radiosonde observations of atmospheric thermodynamic profiles. The
algorithm is trained to estimate TMR at K- and V–W-band frequencies (22–31 and
72–82 GHz, respectively) from independent MWR observations at the V band
(54–58 GHz). The retrieval coefficients are then applied to a 1-year dataset of real
V-band observations, and the estimated TMR at the K and V–W band is compared with
estimates from nearly colocated and simultaneous radiosondes. The proposed method provides
TMR estimates in better agreement with radiosondes than a traditional method, with
32 %–38 % improvement depending on frequency. This maps into an expected improvement in
atmospheric attenuation of 10 %–20 % for K-band channels and ∼30 % for V–W-band
channels.