bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and safety of the different endoscopic resection methods for 10- to 20-mm nonpedunculated colorectal polyps
Authors: Yuan Xin , Gao Hui , Liu Cenqin , Cui Hongyao , Zhang Zhixin , Xie Jiarong , Lu Hongpeng , Xu Lei 
Published: October 2021

Background:
We performed a systematic review and pooled analysis to assess the effectiveness and safety of different endoscopic resection methods for 10- to 20-mm nonpedunculated colorectal polyps.

Methods:
Articles in PubMed, EMBASE, and the Cochrane Library related to the common endoscopic treatment of 10- to 20-mm nonpedunculated polyps published as of April 2020 were searched. Primary outcomes were the R0 resection rate and en bloc resection rate. Secondary outcomes were safety and the recurrence rate. Meta-regression and subgroup analysis were also performed.

Results:
A total of 36 studies involving 3212 polyps were included in the final analysis. Overall, the effectiveness of resection methods with a submucosal uplifting effect, including endoscopic mucosal resection (EMR), cold EMR and underwater EMR (UEMR), was better than that of methods without a nonsubmucosal uplifting effect [R0 resection rate, 90% (95% confidence interval (CI) 0.81–0.94, I2= 84%) vs 82% (95% CI 0.78–0.85, I2= 0%); en bloc resection rate 85% (95% CI 0.79–0.91, I2= 83%) vs 74% (95% CI 0.47–0.94, I2= 94%)]. Regarding safety, the pooled data showed that hot resection [hot snare polypectomy, UEMR and EMR] had a higher risk of intraprocedural bleeding than cold resection [3% (95% CI 0.01–0.05, I2= 68%) vs 0% (95% CI 0–0.01, I2= 0%)], while the incidences of delayed bleeding, perforation and post-polypectomy syndrome were all low.

Conclusions:
Methods with submucosal uplifting effects are more effective than those without for resecting 10- to 20-mm nonpedunculated colorectal polyps, and cold EMR is associated with a lower risk of intraprocedural bleeding than other methods. Additional research is needed to verify the advantages of these methods, especially cold EMR.
Adherence to oral HIV pre-exposure prophylaxis among female sex workers in Kampala, Uganda
Authors: Kakoola Nalukwago Grace , Bosco Isunju John , Muwonge Timothy , Katairo Thomas , Bunani Nelson , Semitala Fred , Kyambadde Peter , Matovu Flavia 
Published: October 2021

Introduction: In Kampala Uganda, female sex workers (FSWs) have high HIV prevalence (33%). Oral PrEP is a novel HIV prevention intervention that offers hope to decrease HIV incidence in key populations especially among FSWs. Studies have shown that with poor adherence, oral PrEP has no efficacy, and therefore adherence to PrEP is critical among FSWs to maximize HIV prevention. However, implementation data on adherence to PrEP among FSWs is limited so this study sought to assess adherence to PrEP. Specifically, we sought to 1) determine the level of adherence to PrEP among FSWs, and 2) determine factors associated with PrEP adherence.
Methods: This cross-sectional study was conducted from November to December 2018; 126 FSWs using PrEP were inter- viewed using a questionnaire. Adherence was categorically defined as high adherence and low adherence. Logistic regression was done.
Results: Using long-term contraception methods (OR 0.06, 95% CI: 0.04-0.77) and not using condoms with clients (OR 0.07, 95% CI: 0.01-0.42) were negatively associated with high PrEP adherence.
Conclusion: Barriers to PrEP adherence need to be addressed for successful PrEP implementation to improve adherence going forward. Service care providers should reinforce positive behaviors such as use of condoms devotedly during PrEP breaks.
Keywords: Oral PrEP; adherence; female sex workers.
Knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at a regional hospital in the north east of Namibia
Authors: Opotamutale Ashipala Daniel , Shikukumwa Getruida , Hangula Joel Medusalem 
Published: October 2021

Background: In sub-Saharan Africa, over 1,000 newborns are infected with HIV every day, despite available medical in- terventions. Mother-to-child transmission (MTCT) remains one of the primary sources of HIV infection in children and without interventions 40% of babies born from HIV-positive mothers would be infected with the virus. It is estimated that 300 000 children become infected with HIV worldwide, whilst 1.5 million children die when their mothers opt for other choices instead of breastfeeding.
Objective: The purpose of the study was to assess and describe the knowledge, attitudes and practices of HIV-positive mothers regarding the benefits of exclusive breastfeeding at Rundu Intermediate Hospital, Kavango East Region in Namibia.
Method: The study was a descriptive cross-sectional survey that used convenience sampling, as the researcher sought to use subjects available during the time of study to select 79 HIV positive mothers.
Results: Participants in this study (94%; n=51) had good knowledge of the benefit of exclusive breastfeeding and that the benefits of breastfeeding outweigh the risk of HIV transmission from mother to child. The results confirmed that (77.2%; n=42) of the mothers opted to take ART with the babies until they stop breastfeeding.
Conclusion: HIV positive mothers had good knowledge, attitudes and practices regarding the benefits of exclusive breast- feeding. A significant number of mothers were, however, not sure about breastfeeding exclusively for 6 months as they would stop if offered free formula milk for the baby. Support by the fathers and others in the community is vital.
Keywords: Knowledge; HIV; breastfeeding; attitudes; practices; HIV-positive mothers; Namibia.
Anatomical variations of the renal artery: a computerized tomographic angiogram study in living kidney donors at a Nigerian Kidney Transplant Center
Authors: Aremu Abayomi , Igbokwe Martin , Olatise Olalekan , Lawal Ahmad , Maduadi Kester 
Published: October 2021

Background: Understanding of the renal vascular anatomy is key to a safe and successful donor nephrectomy, which ulti- mately impacts on the renal graft function and survival in kidney transplant recipients.
Objective: To report the various anatomical configurations of the renal artery identified in living kidney donors in a Nige- rian kidney transplant institution .
Materials and Methods: The computerized tomography angiograms of 100 consecutive living kidney donors were pro- spectively reviewed over an 18-month period. Anatomical variations of the renal arteries including accessory arteries and early divisions were noted. Duration of surgery and ischemic time were recorded intra-operatively. Data analysis was carried out using IBM SPSS version 20.
Results: There were variations in renal artery configuration in 50 (50%) cases, 32% were accessory renal arteries while 18% were early branches of the renal artery. The classical bilateral solitary renal arteries were found in 50 (50%) of potential do- nors. There was statistically significant longer operating and ischemic time in donors with multiple renal arteries as compared with solitary arteries (p<0.05).
Conclusion: There are a wide variety of renal artery configurations seen in potential kidney donors. The classical solitary renal artery remains the commonest and most favourable configuration for donor nephrectomy and transplantation.
Keywords: Renal artery; variations; living kidney donors.
Inflammatory cytokines and sleep parameters response to life style intervention in subjects with obese chronic insomnia syndrome
Authors: M Al-Sharif Fadwah , M Abd El-Kader Shehab 
Published: October 2021

Background: Chronic primary insomnia is a prevalent sleep disorder that is associated with adverse effects on health out- comes. Sleep disturbance is usually associated with abnormal level of systemic inflammation biomarkers.
Objective: The aim of this study was to detect changes in sleep quality and inflammatory markers following weight loss among subjects with chronic primary insomnia.
Material and Methods: Eighty previously sedentary subjects with chronic primary insomnia subjects enrolled in this study, their age ranged from 32-51 year were randomly assigned to life style intervention group (group A, n=40) or control group (group B, n=40). Polysomnographic recordings for sleep quality assessment, IL-6, IL-10 and TNF-α were measured before and at the end of the study after six months.
Results: There was a significant increase in the total sleep duration, sleep efficiency, sleep onset latency and IL-10 in addi- tion to significant reduction in awake time after sleep onset, REM latency, IL-6 and TNF-α after 6 months of in group(A) as a result of weight loss program; while the results of the control group (group B) were not significant. Also, there were significant differences between both groups at the end of the study.
Conclusion: Life style intervention modulates systemic inflammatory parameters and sleep quality among subjects with chronic primary insomnia.
Keywords: Chronic primary insomnia; inflammatory cytokines; life style intervention; sleep quality.
Prevalence of sickle cell trait and its association to renal dysfunction among blood donors at university of medical sciences teaching hospital, Ondo, Nigeria
Authors: Ayodeji Akinbodewa Akinwumi , Ogunleye Adeyemi , Ademola Adejumo Oluseyi 
Published: October 2021

Introduction: Prospective blood donors are routinely screened for blood borne infections but medical illnesses and haemo- globin genotype are overlooked despite a high prevalence of haemoglobin AS among Nigerian donors.
Objective: To determine the prevalence of haemoglobin AS and its association to renal function, if any.
Method: Apparently healthy donors were studied between February and December 2018. Their haemoglobin genotype and, estimated glomerular filtration rates were determined.
Results: There were 96 males (94.1%) and 6 (5.9%) females with mean age of 26.7±4.5 years (range 19-44 years) and mean eGFR of 103.97±19.00ml/min/1.73m2. Eighty one (79.4%) and 21 (20.6%) subjects had haemoglobin AA and AS geno- types respectively. The mean eGFR for subjects with haemoglobin AA and AS were 105.2±18.6ml/min/1.73m2 and 99.9 ± 21.2ml/min/1.73m2 respectively (p value = 0.270). Eighty one (79.4%), 20 (19.6%) and 1 (1.0%) subjects had renal function at >90ml/min/1.73m2, 60-89ml/min/1.73m2 and 30-59ml/min/m2 respectively. There was no significant difference in the mean eGFR between subjects with haemoglobin AA and AS (mean difference 5.3, p = 0.265, 95%CI = -4.07 to 14.60).
Conclusion: The prevalence of sickle cell trait among Nigerian blood donors is high. There is no significant difference in the renal function status of blood donors with SCT and normal haemoglobin genotype.
Keywords: Haemoglobin genotype; sickle cell trait; renal function; blood donor; Nigeria.
Presentation, etiology and treatment outcome of neovascular glaucoma in Ekiti state, South Western Nigeria
Authors: Ajayi Iyiade , Omotoye Olusola , Ajite Kayode , Abah Emmanuel 
Published: October 2021

Background: Neovascular glaucoma (NVG), a form of secondary glaucoma has varying causes across geographical loca- tions.
Objective: The objective of this study was to determine the presentation, aetiology, and outcome of treatment of patients with NVG in a Nigerian tertiary hospital.
Method: A retrospective review of records of all cases of NVG seen over a 5year period was carried out. Demographic characteristics, presenting visual acuity and coexisting ocular and systemic conditions were noted. Data were analysed with Statistical Package for Social Sciences (SPSS) version 25.
Results: 29 eyes of patients with NVG were analysed. Most of the patients (89.70%) presented with visual acuity less than 3/60 in the affected eye. All patients except one were treated with anti-glaucoma medications while only 9(31%) consented to and received anti-vascular endothelial growth factor. No patient had improvement in visual acuity despite resolution of other symptoms at 12week follow up.
Conclusion: NVG though not as common as other forms of glaucoma accounted for a large proportion of monocular blindness in the affected eyes at presentation. There is need for health promotion and education among our people on the need for early preventive eye check practices.
Keywords: Neovascular glaucoma; retinal ischemia; rubeosis iridis; secondary glaucoma.
Pitfalls and technical errors in the first approach to neonates with anorectal malformations in a non-specialist context: can we do any better? A review from three Eastern African Centres
Authors: Calisti Alessandro , Abdelgalil Nugud Faisal , Belay Kibreab , Mlawa Agnes , Lelli Chiesa Pierluigi 
Published: October 2021

Introduction: In sub-Saharan Africa, Anorectal malformations (ARM) are the most frequent cause of neonatal obstruc- tion. Referral to a Pediatric Surgeon is frequently delayed. The first treatment is often delivered at not specialist level and mismanagement may result.
Aim: To study ARM patients referred beyond neonatal period and managed at a non-specialist level.
Materials and Methods: One hundred and thirty patients were included (M/F ratio 63/67) among 144 admitted to three Eastern African Hospitals with Pediatric Surgical facilities. Demographics, type of anomaly, delay on referral, previous man- agement, most commonly observed errors are reported.
Results: The Mean age at referral was 23 months (range five weeks – 23 years). Colostomy was the most frequent surgery (92 cases). Stomas often did not follow the recommended criteria. Ten per cent were not on the sigmoid, and 35% were not divided. "Loop" or "double-barrel" colostomies did not exclude the distal loop. Inverted (10,5%), prolapsed stomas (7,5%), short distal loop (16%) were observed. Twenty-four cases (26%) needed redo. Primary perineal exploration in eight patients resulted in incontinence.
Conclusions: Investments on training practitioners, acting at District/Rural level, and closer links with tertiary centres are recommended to avoid ARM mismanagement and delayed referral to a Specialist.
Keywords: Ano rectal malformations; neonate; low resources context.
Systematic review and meta-analysis assessing the knowledge and use of the female condom among Nigerians
Authors: Dauda Shallie Philemon , Haffejee Firoza 
Published: October 2021

Background: The female condom (FC) is a critical component in a comprehensive and sustainable approach to prevent HIV, other sexually transmitted infections and unintended pregnancies.
Objectives: This review provides comprehensive information about Nigerian’s knowledge and use of FC.
Methods: We screened search output, evaluated study eligibility, and extracted data in duplicate. Data from similar studies were combined in a meta-analysis.
Results: There was a significantly (p < 0.0001) high-level of awareness amongst the respondents. However, the use of the FC was very low at 5.5% among female respondents. There was a significant (p < 0.0001) difference between FC awareness and use. The main reasons for FC use were prevention of unintended pregnancy (55%) and STIs/HIV (31%). We observed a significant difference between reasons of non-use of the FC [F (5, 13) = 5.195, P = 0.0077]. Furthermore, there were significant differences between the sources of information on FC [F (3, 8) = 32.89, P < 0.0001].
Conclusion: Despite the high levels of awareness, especially among the female respondents, the use of the FC has remained extremely low even among the young, educated undergraduate students. There is aneed for robust and consistent advocacy to make the FC available and affordable.
Keywords: Female condom; women; men; awareness; use; Nigeria.
It is not always Tuberculosis! A case of pulmonary cryptococcosis in an immunocompetent child in Uganda
Authors: Nakatudde Irene , Kasirye Phillip , Kiguli Sarah , Musoke Philippa 
Published: October 2021

Pulmonary cryptococcosis is rare in immunocompetent individuals. Limited data exist regarding its occurrence in children, especially in developing countries. This case report describes an 8-year-old HIV-negative child with pulmonary cryptococco- sis, previously diagnosed and treated for tuberculosis twice without improvement. Fine needle aspiration biopsy confirmed the diagnosis of pulmonary cryptococcosis and serum cryptococcal antigen test was positive. The child improved on am- photericin and fluconazole treatment. Despite the limited diagnostic capacity in many resource-constrained settings like Uganda, this case report highlights the need to investigate other causes of pneumonia in immunocompetent children that are not improving on conventional antimicrobial treatments.
Keywords: Pulmonary cryptococcosis; immunocompetent; children; Uganda.
Disability management in a public-private health care facility in South Africa: an organisational perspective
Authors: Govender Rubendri , Govender Pragashnie , Naidoo Deshini 
Published: October 2021

Background: Job retention, long-term absenteeism and medical boarding pay-outs are significant concerns for employers with- in the public health care sector of South Africa.
Objective: To describe disability management policies, procedures and programmes of employees following impairment and disability in a public-private healthcare facility in South Africa.
Methods: An exploratory qualitative study design was used with key informants in senior management and nursing managers (n=12) selected via purposive sampling. Audio-recorded data from semi-structured interviews and a focus group were themati- cally analysed using inductive reasoning.
Results: There is poor adherence to occupational health and disability management policies and the current referral process is informal with managers using discretion to manage employees with ill health and acquired disability. The procedures prescribed in the policy and procedure on incapacity and ill-health-retirement need to be followed, and an early return to work programme within the health care facility needs to be implemented.
Conclusions: Despite South Africa having many policies on recruitment and reasonable accommodations, there is a lack of implementation of these policies. An integrated disability management policy and programme encompassing health prevention, early return to work strategies, vocational rehabilitation and the implementation of reasonable accommodation is required to ensure that employees who have acquired disabilities or ill health are successful in the workplace.
Keywords: Disability management; vocational assessments; return to work.
New trend of drugs abused by secondary school students in Nigeria
Authors: E Nabofa Ochuko 
Published: October 2021

Background: It appears that there is a new trend in the types of drugs abused by secondary school students in Nigeria that makes it difficult to identify current drug abusers.
Objectives: This study was conducted to reveal the trends with regards to the types of drugs abused by these students in the country.
Methods: This is an online and desktop review of published articles about the types of drugs abused by secondary school students during the period that spanned from 2010–2020.
Results: In all, 17 research reports were identified as having data on the types of drugs abused by secondary students in the Nigeria. It was found that 18 different drugs were empirically identified as being abused by secondary school students in 9 different states of Nigeria. The observed trend is that alcohol, cannabis, tobacco and cigarettes are the most abused drugs, while drugs that were least abused were cocaine, caffeine, glue, heroine, energy drinks, miraa, rohypnol and tramadol.
Conclusion: It was concluded that studies of drug abuse by secondary school students in Nigeria are not yet robust enough to reveal the types of drugs that are currently being abused.
Keywords: Adolescent Health; Drug Abuse; Drug Effects; Drug Safety; Drug Utilisation.
Predictors for tuberculosis co-infection in people living with HIV/AIDS
Authors: Zerdali Esra , Yılmaz Nakir İnci , Sürme Serkan , Sayılı Uğurcan , Yıldırım Mustafa 
Published: October 2021

Background/aim: Tuberculosis (TB) is one of the most common chronic infectious conditions causing mortality and se- vere outcomes, particularly in people living with HIV/AIDS (PLWHA). In this study, we aimed to determine the prevalence and predictors of TB among PLWHA.
Materials and methods: We conducted a retrospective and single-center study of adults (≥18 years) PLWHA registered at our tertiary teaching and research hospital between 2000 and 2016.
Results: A total of 711 PLWHA were included. Of whom, 633 (89.0%) were male. Mean age was 36.53 ±11.55 years (range, 17-79). Thirty-eight (5.3%) patients were diagnosed with active TB. TB development was associated with low CD4+ lymphocyte count (p<0.001), high viral load (p=0.040) and alcohol consumption (p=0.004) but no association with age (p=0.392), gender (p=0.928) and duration since anti-retroviral therapy initiation (p=0.788) was found. Also, a receiver operating characteristic analysis showed that the area under the curves of CD4+ lymphocyte count as a predictor for TB development in PLWHA was 0.717 (p<0.001).
Conclusion: There are still clinical challenges to predict TB diagnosis. However, CD4+ lymphocyte count and viral load may be considered as valuable predictors for TB development. Also, community strategies to reduce harmful effect of alco- hol use should be developed.
Keywords: Tuberculosis; HIV viral load; CD4 cell counts.
SRY and NR5A1 gene mutation in Algerian children and adolescents with DSD and testicular dysgenesis
Authors: Kherouatou-Chaoui Naouel , Chellat-Rezgoune Djalila , Larbi Rezgoune Mohamed , Mc Elreavey Ken , Souhem Touabti Laaldja , Abadi Noreddine , Satta Dalila 
Published: October 2021

Background: In humans, sex determination and differentiation is genetically controlled. Disorders of sex development (DSD) result in anomalies of the development of the external and internal genitalia. Variants in transcription factors such as SRY, NR5A1 and SOX9, can cause changes in gonadal development often associated with ambiguity of the external genitalia.
Objectives: This study has been conducted to determine the frequency, types and associated genetic alterations in patients with DSD in the Algerian population.
Methods: Thirty patients were included. Based on their clinical presentation, thirteen patients presented with ambiguous external genitalia, thirteen patients presented with hypospadias and four patients presented with bilateral undescended tes- tes. Karyotype analysis was performed on peripheral blood lymphocytes using standard R-banding. DNA was isolated from blood leukocytes for PCR reaction and mutational analysis of SRY and NR5A1 was done by direct sequencing.
Results: Most patients with ambiguous genitalia had a 46,XY karyotype. One patient had a deletion of SRY, otherwise no point mutations in SRY or NR5A1 genes were identified. However, a single NR5A1 polymorphism (p.Gly146Ala) in patient with 46,XX DSD has been detected.
Conclusions: The absence of mutations in these genes suggests that there are others genes playing an important role in sex development and differentiation.
Keywords: DSD; consanguinity; karyotyping; SRY; NR5A1; sequencing.