bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum interleukin-33 level may serve as a new marker for psoriasis diagnosis
Authors: AbdelWahed Mai A. , Elmogy Mohammed H. , Abdelsalam Maha , Zohdy Marwa 
Published: June 2021

Background
Psoriasis is a Th1/Th17 disease resulting from a dysregulated interplay between keratinocytes and immune cells, leading to skin hyperproliferation. Increased levels of interleukin (IL)-33 were reported in various Th1/Th17-driven autoimmune diseases, such as rheumatoid arthritis and inflammatory bowel disease, with correlation to disease severity. Increased levels of IL-33 have been reported in lesional skin of psoriatic patients. The authors hypothesized that keratinocyte-released IL-33 might play a role in psoriasis pathogenesis; thus, inhibiting IL-33 activity might be a breaking new therapeutic strategy in its treatment.

Patients and methods
Serum IL-33 levels were measured by an enzyme-linked immunosorbent assay for 30 patients with active psoriasis (group A), 30 patient with stable psoriasis (group B), and 30 healthy age-matched and sex-matched controls (group C).

Results
Serum IL-33 showed statistically significant higher mean value among patients with psoriasis compared with the control group. The level of IL-33 in active psoriasis was significantly higher than in inactive psoriasis. Moreover, there was a statistically significant correlation between IL-33 and psoriasis area and severity index (PASI) score. Receiver operating characteristics curve detected the validity of serum IL-33 in differentiating patients with psoriasis from controls. At the cutoff point of IL-33 as 22.72 pg//ml, psoriasis could be predicted with 96.67% sensitivity and 93.33% specificity. Serum IL-33 was a statistically significant predictor of PASI score, with 63.5% of PASI scores predicted by serum IL-33.

Conclusion
Serum IL-33 may represent a new marker for psoriasis diagnosis as well as a predictor of the disease severity.
Does breastfeeding delay the onset of eczema in infants?
Authors: Al-Abadie Mohammed , Beer Greg , Al-Rubaye Mohammed , Oumeish Faris , Abadie Dina Al 
Published: June 2021

Background
Cow’s milk has been shown to contribute to flare-up of atopic dermatitis, whereas breastfeeding was thought to help reduce the severity of the flare-ups of the condition.

Aim
To investigate whether breastfeeding or cow’s milk (bottle formula) has an influence on the course of and onset of atopic dermatitis symptoms. Three feeding modalities were evaluated. These are ‘breastfed,’ ‘bottle-fed,’ or ‘breast and bottle-fed.’

Patients and methods
Medical records from general practice of patients aged 2 years or less with diagnosis of eczema, atopic dermatitis, atopic eczema, and infantile eczema were reviewed. A cohort of 131 patients was divided into three categories: (a) breastfed, (b) bottle-fed, and (c) breast and bottle-fed.
These data were studied according to the data recorded at the 6-week infant health checkup. The age of the child at their first eczematous diagnosis was then calculated in accordance with their date of birth.

Result
New eczema diagnosis showed a similar trend in ‘breast-fed’ babies; however, onset of eczema was significantly delayed in the ‘breast and bottle-fed’ group when compared with bottle-fed alone. Most bottle-fed babies (58% of patients) were diagnosed at 31–60 days, whereas most ‘breast and bottle-fed’ babies (56%) were diagnosed at 91–120 days (P≥0.0001).

Conclusion
Babies from the two groups (‘breast’ and ‘breast and bottle-fed’) experienced a delayed onset of their eczema compare with ‘bottle-fed’ infant group. Breastfeeding can delay the onset of atopic dermatitis.
COVID-19 clinical course and outcomes in a predominantly black, vulnerable patient population in New York City
Authors: Parmar Priyanka , James Alecia , Rosengarten Sabrina , Oommen Alvin , Joseph Michael A. , Wilson Clara , Maini Rohan , Mecklenburg Max , Kim Julie , Edwards Jodi-Ann , Nakeshbandi Mohamed , Breitman Igal , Arquilla Bonnie , Daniel Pia 
Published: June 2021

Introduction:
A study examining the impact of social determinants of health on COVID-19 outcomes is necessary to identify which aspects of a vulnerable population make it more susceptible. We describe the epidemiological and clinical characteristics of a patient population disproportionately impacted by COVID-19 and situate the findings within the broader context of health determinants.

Materials and Methods:
A descriptive study of 527 laboratory-confirmed COVID-19 patients hospitalized from March 12 to April 13, 2020, evaluated patient demographics, comorbidities, presentation, and outcomes. The study took place at an academic medical center serving a low-income, Black community (predominantly Caribbean-born) in Brooklyn, New York.

Results:
Compared to previous studies, we report a higher median age of 70 (interquartile range 59–80), a higher percentage of Blacks (91%), a higher prevalence of comorbidities (hypertension [83%], diabetes [53%], and obesity [42%]), a higher prevalence of abnormal findings on presentation (altered mental status [30%], Quick sequential organ failure assessment score ≥2 [27%], elevated random-glucose [77%], elevated creatinine [57%]), and a higher incidence of negative in-hospital outcomes (intensive care unit admission [21%], mechanical ventilation [21%], acute kidney injury [31%], acute respiratory distress syndrome [17%] and acute cardiac injury [18%], and age-adjusted fatality rate [40%.]).

Conclusions:
This study shows the characteristics of a patient population disproportionately impacted by COVID-19. The intersectionality of the Black race, older age, a high prevalence of comorbidities, and residency in a locale severely affected by COVID-19, deserves further consideration to better address health outcomes in vulnerable patient groups.

The following core competencies are addressed in this article:
Practice-based learning and improvement, Patient care and Procedural skills, Systems-based practice.
Knowledge, attitude, and practices regarding COVID-19 outbreak among the personnel providing emergency services in India
Authors: Bhushan Vidya , Rai Shilpa 
Published: June 2021

Introduction:
The threat of contracting coronavirus persists among individuals constantly coming in direct or indirect contact with positive cases. Therefore, this study was conducted to assess the knowledge, attitude, and practices (KAPs) regarding the COVID19 outbreak among the personnel providing emergency services in India and also assess their perception toward government measures during this pandemic.

Materials and Methods:
An online survey was conducted among individuals providing services during the period of COVID-19 outbreak. A total of 234 people consented to continue with the survey. Data collection was carried out from April 2020 to June 2020. Data analysis was carried out using Chi-square statistics and Fisher-Freeman-Halton test. The level of statistical significance was set at 0.05 with a confidence interval of 95%.

Results:
Majority of the participants were male and belonged to the age group of 18–54 years. Almost all were aware that COVID-19 is a virus and had knowledge regarding its mode of spread and modes of prevention. Precautions such as covering face with mask, avoiding shaking hands, and washing hands before touching the eyes, nose, and mouth were undertaken by 34.6% of the total participants. Around 70.5% of the males, 53.7% of the females, and 33.3% of the participants from the others' category felt that the funds released by the government to combat corona were efficiently reaching the poor or the needy. Some of the barriers preventing the fair distribution of funds/services to the poor and needy as reported by the participants were corruption, lack of knowledge, delay in delivery and lack of personal protective kits, limited workforce, and no bank account of poor people.

Conclusion:
KAP of personnel providing emergency services is crucial to the containment of this disease. Understanding of the barriers shall aid policymakers to assess the impact of their preventive programs and also take crucial decisions toward its management.

The following core competencies are addressed in this article:
Medical knowledge, practice-based learning and improvement, and systems-based practice.
Coverage assessment of maternal and child health services provided at Urban Health and Nutrition Day in urban slums of Jamnagar Municipal Corporation area
Authors: Khan Mubashshera Firdous , Kotecha Ilesh S. 
Published: June 2021

Introduction:
Urban Health and Nutrition Day (UHND) is an initiative to provide preventive, promotive, and curative maternal and child health services monthly on fixed day. It is mainly designed to reach out to those who are living in urban slums and for serving vulnerable. The study was conducted to assess the utilization of services provided to mother and child at Mamta session.

Materials and Methods:
A cross-sectional study was conducted in urban slums of Jamnagar. In the first stage, 30 Anganwadi centers were chosen by systematic random sampling, and in the second stage, 8 postnatal women with 8 children were included.

Results:
Out of 240 participants, 80% of women registered their pregnancy at Mamta session and 86% were having Mother and Child Protection Card at the time of visit. Basic health checkups containing blood pressure and weight were measured for around 90%, three-fourth of women were checked for hemoglobin % and urine for albumin, and only 29% were done with abdominal examination. Health education component was found to be much-sidelined portion of UHND session in both mother and child care in this study. From surveyed children, 81.6% were registered at session site; from those registered, 62% attend the session regularly; 80% of children were weighed; only 12% of children's weight was recorded in Mamta card; and 50% of mothers were explained about weight and its interpretation. Fifty-four percent of women had given colostrum to their babies, and the same proportion of mother gave prelacteal feed to their children.

Conclusion:
There is a need to sensitize health workers about the importance of giving health education to mothers which is found to be the most poorly executed component of the study.
Safety and efficacy of thromboelastography guidance of antifibrinolytic therapy in trauma patients
Authors: Heilbronner Rachel N. , Kincaid Michelle , Walliser Grant , Pershing Michelle , Spalding M. Chance 
Published: June 2021

Background:
Tranexamic acid (TXA) is an antifibrinolytic therapy intended to decrease blood loss and improve hemostasis in traumatic hemorrhage. Viscoelastic assays, such as thromboelastography (TEG), allow for the identification of a patient's specific hemostasis. The purpose of this research study was to explore the safety and efficacy of TEG-guided antifibrinolytic therapy in trauma patients.

Methods:
This study was a retrospective review of trauma patients meeting institution-specific inclusion criteria for TXA. Patients were assigned to fibrinolytic groups per TEG LY30 data. Safety outcomes (24-h mortality, overall in-hospital mortality, and thromboembolic events) were compared between patients who did or did not receive TXA and within fibrinolytic groups. Mortality outcomes were adjusted for baseline Injury Severity Score (ISS). Secondary aims included blood product utilization, length of hospital, and intensive care unit stay.

Results:
Hypofibrinolysis was the most common fibrinolytic phenotype. Adjusting for ISS, there were no significant differences in mortality. A 30.7% thromboembolism incidence was identified in the TXA group compared to 16.6% not receiving TXA (P = 0.26), with 72.7% of these patients experiencing fibrinolytic shutdown.

Conclusions:
There were no differences in 24-h mortality, all-cause mortality, or secondary outcomes. The difference in thromboembolic rates between patients receiving TXA and those who did not, while not statistically significant, poses clinical concern.
Serum total triiodothyronine (T3) as a predictor of mortality and morbidity in critically ill patients and its correlation of predictability with acute physiology and chronic health evaluation II score
Authors: Thilak M R , Shetty Seema M. , Kotian Chitra M. , Mohammed Afsal P. , Dhunputh Pushwinder , Umakanth Shashikiran , Saraswat Pallavi P. 
Published: June 2021

Background:
The aim is to assess the prognostic value of total T3, total T4, and thyroid-stimulating hormone among critically ill patients admitted to the medical intensive care unit (ICU) in association with mortality and its correlation with the acute physiology and chronic health evaluation II (APACHE II) score.

METHODS
: Our prospective observational study consists of 257 patients without known thyroid diseases admitted to the medical ICU. The baseline characteristics of the patients were recorded, including the APACHE II score and thyroid hormone levels at ICU admission. Based on the primary outcome of mortality, we analyzed the data by appropriate statistical methods. A P < 0.05 was considered significant.

Results:
Of the 257 patients included in the study, 47 (18.28%) succumbed to their illnesses. A significant difference in T3 levels (P < 0.001), T4 levels (P < 0.001), and APACHE II score (P < 0.001) was found between the survivors and the nonsurvivors. There was negative correlation observed between T3 and APACHE II score (r = −0.448, P < 0.001) and T4 and APACHE II score (r = −0.221, P ≤ 0.001). Multivariate logistic regression analysis determined T3 to be the only independent predictor of ICU mortality among thyroid hormones. The area under the curve (AUC) for T3 (0.811 ± 0.04) was almost equal to that of the APACHE II score (0.858 ± 0.029). The duration of ICU stay and hospital stay in patients with low T3 was significantly higher compared to patients with normal T3.

Conclusion:
Serum T3 is a good indicator for predicting mortality and morbidity among critically ill patients.
Neurogenic Tumors of Parapharyngeal Space – Clinical Evaluation and Management
Authors: Bharathi MB , Rakesh BS , Rudrappa Babu Amabale , Aggarwal Nitish , de Kumar Shankar 
Published: June 2021

Context:
Neurogenic tumors are the second most common parapharyngeal space (PPS) lesions, with schwannoma being the most common neurogenic tumor seen. PPS tumors account for 0.5% of all head-and-neck masses, and most surgeons might not encounter it in their lifetime. Anatomical complexity and histological diversity of PPS pose various diagnostic and treatment challenges. Relevant literature about lesions of this space is growing but is still limited.

Aims:
The aim of our study was to evaluate neurogenic tumors of PPS and their management over a period of 5 years.

Settings and Design:
A retrospective study was conducted in our institution for a duration of 5 years from January 2014 to December 2018.

Materials and Methods:
Clinical features were analyzed. All patients were subjected to radio imaging-contrast-enhanced computerized tomography and contrast magnetic resonance imaging, and findings were noted. After imaging, patients were subject to fine-needle aspiration cytology. Transcervical approach was used for 11 cases and endoscopic-assisted transoral transpharyngeal approach (EATA) used for 4 cases.

Results:
A total of 27 patients with PPS tumors were evaluated and treated. The incidence of neurogenic tumors was 55.5% (15 cases). Out of the 15 patients with neurogenic tumors, 11 cases were schwannomas, 1 case was vagal neurofibroma, and 3 cases were paragangliomas from the carotid body.

Conclusions:
Neurogenic tumors of PPS are more common than traditionally thought. Neck swellings and oropharyngeal masses are the most common presenting features. FNAC is a very useful tool to establish a preoperative cytological diagnosis. Both external approach and EATA are effective approaches, provided that careful patient selection is done.
The Nescience of the Art of Conversing and Making the Shift Happen
Authors: Pendyala Gowri , Joshi Sourabh Ramesh , Mani Ameet , Mopagar Viddyasagar , Kale Preeti 
Published: June 2021

Background:
Motivational interviewing (MI), a patient-centered therapeutic approach, has demonstrated to be effective for a wide range of health behaviors including dentistry. It resolves patient's ambivalence by evoking their own motivation to change, thereby improving clinical outcomes and enhancing clinician patient relationship.

Objective:
The aim of this study is to evaluate the knowledge and awareness of dental clinicians about MI and predict the likelihood of their use of the MI approach.

Methodology:
A cross-sectional survey was used to collect data. In total, a purposive sample of 600 dentists including dental professionals, postgraduate students, and interns inclusive of both genders participated in the study.

Results:
The results of this study indicated that dentists had inadequate knowledge about MI and also their practical implication was less.

Conclusion:
The results of this study may contribute to positive social change by supporting the development of effective training for dental clinicians as MI is helpful in enhancing patient awareness and obedience leading to better therapy outcomes.
Role of intramuscular glycopyrrolate in preventing hypotension after subarachnoid block in elderly patients
Authors: Gargava Aseem , Arya Monay , Dali Jaspal Singh , Sharma Kavita 
Published: June 2021

Background
Hypotension is one of the most frequent complications during spinal anaesthesia. It is more common in elderly with a reported incidence of 65–75%. While keeping in mind that the hypotension induced by subarachnoid block is related to sympathetic blockade accompanied with bradycardia, the administration of glycopyrrolate could affect hemodynamic during spinal anaesthesia. Thus, we aimed at evaluating the role of intramuscular glycopyrrolate in preventing hypotension after subarachnoid block in elderly patients.

Patients and methods
It’s a randomized double blind study. Forty four patients (60–80 years of age, ASA I and II) posted for lower abdominal surgery or lower limb surgery were given subarachnoid block using standard anaesthesia technique. They were administered either 1 ml of normal saline (group N) or 0.2 mg glycopyrrolate (group G) intramuscularly 15 minutes before subarachnoid block. Parameters like blood pressure and heart rate (at preset time intervals), total requirement of ephedrine, time to first rescue vasopressor i.e. ephedrine, incidence of nausea and vomiting and requirement of Ondansetron, incidence of bradycardia and requirement of atropine, presence of dry mouth etc was recorded.

Results
Eleven of 22 (50%) patients in group N experienced hypotension compared with two of 22(9.09%) patients in group G (difference=40.91%; P=0.001). The mean ephedrine requirement in group G is 0.45±1.47 mg while, in group N is 3.63±4.41 mg (P=0.001). There was no case of bradycardia reported in group G although, two out of 22 patients (9.09%) in group N reported bradycardia (P=0.55). There is no incidence of nausea and vomiting in group G while, 3 patients in group N complained about nausea and vomiting (P=0.03).

Conclusion
The intramuscular administration of 0.2 mg glycopyrrolate in elderly patients undergoing subarachnoid block significantly reduces the incidence and degree of hypotension; and reduces the total consumption of rescue vasopressor without any clinically significant side effect.
Fragmented QRS complex and ventricular arrhythmias in patients with myocardial infarction
Authors: Mawla Tamer Sayed Mohamed Abdel , Hameed Asmaa Mizar Abdel , Zaky Sherif Hamed , El khashab Khaled Ahmed 
Published: June 2021

Aim
In our study we aimed to determine whether fragmented wave in electrocadiogram (QRS) (fQRS) is associated with increased incidence of ventricular arrhythmias in patients with coronary artery disease (CAD) or not.

Methods
300 patients with CAD were included. Patients were divided into two groups according to presence or absence of fQRS on admission ECG. Group I (n=51) was defined as fQRS (+ve) and group II (n=249) was defined as a fQRS (-ve). All patients were subjected to full history taking, complete physical examination, and ECG, echocardiography and laboratory investigations.

Results
There was higher incidence of fQRS in hypertensive patients (72.5 %). FQRS was found to be associated with increased incidence of ventricular arrhythmias, 51.1 % in group I versus 25% in group II. EF was significantly lower in group I than in group II with P value <0.0001. Fragmented QRS was an independent predictor of mortality with P value <0.0001.

Conclusion
FQRS on the resting surface electrocardiogram is a simple, fast and inexpensive modality of noninvasive investigation for evaluation of CAD patients. Patients who have known CAD present with a FQRS have increased rates of ventricular tachyarrhythmias, death risk, and low ejection fraction.
Comparing the efficacy of preoperative nebulized ketamine, magnesium sulfate, and lidocaine in attenuating postoperative sore throat after endotracheal intubation
Authors: Kamel Alshaimaa Abdel Fattah , Nasrallah Marwa A. 
Published: June 2021

Background
and objectives Postoperative sore throat is a common complication after endotracheal intubation, and different methods have been proposed to attenuate it. The aims were to compare the intensity of sore throat and the sedation level of preoperative nebulized ketamine, magnesium sulfate, and lidocaine in attenuating postoperative sore throat after endotracheal intubation.

Patients and methods
A prospective comparative double-blind randomized study was conducted on 100 patients who were divided into four groups: group K (n=25) included patients who received nebulized ketamine 50 mg (1 ml) plus 4-ml normal saline; group M (n=25) included patients who received nebulized magnesium sulfate 250 mg (2.5 ml) plus 2.5-ml normal saline, group L (n=25) included patients who received nebulized lidocaine 2% 100 mg (5 ml), and group C (n=25) included patients who received nebulized normal saline 5 ml (control group). So, total volume used was 5 ml. Patients were preoperatively nebulized by compressor nebulizing for 15 min.

Results
Sore throat scores were statistically significant lower (0 and 1 point) in group L and group K at 0, 2, and 4 h compared with group C and group M (P<0.05). Group K showed statistically significant lower sore throat scores at 8, 12, and 24 h compared with group L, but statistically significant high sore throat scores (2, 3, and 4 points) compared with group M (P<0.05). The level of sedation assessed using A=alertness, V=response to verbal, P=response to painful stimulus, and U=unresponsive (AVPU) was statistically insignificant among groups (P>0.05).

Conclusions
Preoperative nebulized 100-mg lidocaine and 50-mg ketamine relieves throat pain earlier in the first 24 h after endotracheal intubation, but it persists for shorter duration than 250-mg magnesium sulfate, without any changes in sedation level.