bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Evaluation of Effectiveness of InGaAsP Laser and Therapeutic Ultrasound Administration Before the Induction of Muscle Fatigue on Healthy Young Individuals
Authors: Saini Roopam , Ahuja Upasana Sethi , Puri Nidhi , Ram Chinthalapalli Siva , Dhillon Manu , Rathore Akshay 
Published: October 2021

Background:
Muscle fatigue or the inability to maintain muscle strength is a protective mechanism to prevent muscle injury. Phototherapy or low-level laser therapy (LLLT) and therapeutic ultrasound are non-invasive and non-pharmacological forms of treatment modalities that have demonstrated effective and affirmative results when used to prevent muscle fatigue. Aim: The study evaluated the effect of phototherapy and therapeutic ultrasound in reducing muscle fatigue when administered before the induction of fatigue.

Methodology:
The study design was a blind, randomized, and sham-controlled clinical trial on laser and therapeutic ultrasound. The study sample consisted of 100 healthy young participants randomly allocated to four different groups of lasers, sham laser, therapeutic ultrasound, and sham ultrasound. All the individuals were subjected to clinical examination to record the bite force by the bite force dynamometer, maximum interincisal distance (MID) by using digital vernier calipers, and muscle fatigue by using EMG Retrainer's Device. The laser and therapeutic ultrasound were given on the masseter and anterior temporalis muscle on both sides and both sham groups were submitted to the same procedure but with the devices in the switch-off mode. All the individuals were instructed to chew two pieces of gum (one on each side) for 6 min to induce muscle fatigue and MID, the bite force and muscle fatigue were re-evaluated.

Results:
Statistically significant improvement was observed between the pre-and post-bite force, MID, and muscle fatigue in both the laser and Therapeutic ultrasound group as compared to the sham control groups with the P-value equal to 0.000. No, statistically significant difference was observed in the improvement of the muscle fatigue when both the treatment groups, i.e., laser and therapeutic ultrasound were compared with a P value >0.05.

Conclusion:
Muscle fatigue can be effectively reduced if any one of the physical modalities, either laser or therapeutic ultrasound is administered before the long-duration treatments; enabling administration of treatment comfortably and effectively in one appointment.
To Compare the Effect of Conventional Radiotherapy versus Concurrent Chemoradiotherapy on the Thyroid Gland after External Beam Radiotherapy in Head-And-Neck Carcinoma
Authors: Gupta Surabhi , Upadhyay Shashi Bhoosan , Yadav Sarvesh , Singh Hari , Tyagi Anuj Kumar 
Published: October 2021

Introduction:
Radiotherapy-induced hypothyroidism has remained underestimated and under reported ailment, because of noninclusion of routine assessment of thyroid function test in baseline workup and during follow-up protocol, which results in failure to detect and treat a reversible cause of morbidity in significant proportion of surviving patients. Greater magnitude and duration of thyroid-stimulating hormone elevation increase the probability of progression to clinical hypothyroidism and therefore increase the potential benefit of treatment of subclinical hypothyroidism. Hence, recognizing subclinical hypothyroidism at an early stage can prevent clinical hypothyroidism and its associated morbidities.

Aims and Objectives:
The aim of the present prospective study was to evaluate the functional and anatomical changes in thyroid glands in patients with head-and-neck cancer treated with conventional radiotherapy (external beam radiotherapy) and concurrent chemoradiotherapy and to assess the necessity of inclusion of routine thyroid function test in the workup and follow-up protocol of these patients.

Materials and Methods:
A total of 98 patients were randomly allocated in two arms. In arm I, 50 patients received concurrent chemoradiotherapy and in arm II, 48 patients underwent radical conventional radiotherapy alone. Baseline thyroid function test and ultrasonography of neck along with thoroughly clinical evaluation were done for every patient and these investigations were repeated in the middle of radiotherapy treatment (after 17 #), at the end of radiotherapy treatment, 3 months after completion of radiotherapy, and after that, at every 3rd-month follow-up to determine late changes in thyroid function test and echotexture.

Results:
In arm I, total 60% patients developed acute hyperthyroidism while in arm II, 68.75% patients developed acute hyperthyroidism. A total of 18.36% patients were found to have subclinical hypothyroidism. At the 9th month of follow-up, 55 out of 98 patients (56.12%) developed hypothyroidism. Among 55 patients, 37 were having clinical hypothyroidism while 18 patients were having subclinical hypothyroidism (P ≤ 0.0001). Maximum number of patients, i.e. 26/98 (47.27%) developing hypothyroidism were between 51 and 60 years of age group. Addition of surgery and chemotherapy had shown no difference in thyroid dysfunction. Patients with clinical hypothyroidism required medical management while patients with subclinical hypothyroidism were kept on close monitoring.

Conclusion:
Recognizing hypothyroidism (clinical or subclinical) early and treating it timely can prevent associated complications which are often ignored. Hence, thyroid function tests should be done routinely that is before starting of radiotherapy, on completion of radiotherapy, and during follow-up as well.
Nasal Colonization and Antibiotic Resistance of Staphylococcus Species Isolated from Healthy Veterinary Personnel at Veterinary Medical Care Facilities in Tripoli
Authors: Ahmed Mohamed Omar , Othman Aesha A. , Abbassi Mohamed Salah , Elnageh Hiam R. , Almshawt Nariman F. , Abouzeed Yousef M. , Hiblu Murad A. 
Published: October 2021

Background/Aim:
Veterinary medical personnel may carry important antibiotic-resistant organisms playing important role in their dissemination and emergence. The purpose of the study was to investigate nasal colonization and antibiotic resistance of Staphylococcus species isolated from veterinary personnel (VP).

Methods:
A total of 47 VP were sampled, whereby nasal samples were subjected to selective and typical laboratory protocols. Presumptive isolates were further confirmed and fully characterized by the Phoenix automated microbiological system then further tested by polymase chain reactions for mecA and panton-valentine leukocidin (pvl) genes.

Results:
A total of 34 (72%) VP were colonized with various species, mostly coagulase-negative staphylococci. A collection of 34 staphylococci isolates were collected of which 21% and 6% were, respectively, positive for mecA and pvl genes expressed exclusively by Staphylococcus aureus and S. epidermidis.

Conclusion:
VP may carry various staphylococci species of public health importance expressing multidrug resistant and virulent traits. Preventative measures and continuous monitoring are required to control the spread of methicillin-resistant staphylococci in veterinary clinics.
Altered leukogram and hematological parameters among leukemia patients
Authors: Yashim Andrew Nuhu , Obazee Dorcas Yetunde , Ajani Olumide Faith , Adewole Opeyemi Matthew , Swem Collins , Abiodun Paul Olaiya , Sanni Olaniyi Felix 
Published: October 2021

Background:
The incidence of leukemia is increasing in developing countries, particularly in Africa. Cancer-associated inflammation is a significant factor in the improvement and survival of people with cancer. This study aimed to evaluate changes in leukogram and other hematological parameters among leukemia patients in Abuja, Nigeria.

Materials and Methods:
The study comprised 30 leukemia patients attending the Oncology Department of National Hospital Abuja, Nigeria, from July 2019 to August 2020, and 20 healthy people. Three milliliters of blood was collected from each participant into an ethylene diamine tetra-acetic acid bottle and analyzed for full blood and differential counts using the Mythic 22 (Orphee, Switzerland) five-part differential hematology analyzer. CD4 and CD8 T cells were analyzed by flow cytometry. Data analysis was done using IBM-SPSS software, SPSS Inc., Chicago, IL, version 25.0. T-test was used to compare means between groups, and the significant value was set as P < 0.05.

Results:
All hematological parameters were significantly lower (P < 0.05) in leukemia patients than those in controls except for monocytes and basophils. In addition, white blood cell count was significantly higher in leukemia patients (13.0 ± 0.57 × 109/L) than that in controls (6.11 ± 1.14 × 109/L) (P < 0.05). CD4 (775.40 ± 82.91 cells/µL) and CD8 counts (634.40 ± 101.43 cells/µL) were significantly higher in controls than those in leukemia patients. Furthermore, CD4/CD8 ratio was significantly higher (P < 0.05) among controls (1.24 ± 0.15) than that in leukemia patients (1.17 ± 0.09).

Conclusion:
The study found that changes in hematological parameters and leukogram are significantly associated with leukemia. The use of therapies to boost immune response in patients with leukemia is recommended.
Knowledge and awareness of ethics among phase 1 medical students
Authors: Sidhu Jaspreet K. , Chopra Deepti , Bhandari Bharti , Singh Surjit , Rai Jayant 
Published: October 2021

Background:
The increasing incidence of disconnect between doctors and patients in India makes it imperative to teach principles and practice of ethics to medical graduates before they move into substantive clinical practices. The competency-based medical education (CBME) curriculum was recently introduced in India. The CBME curriculum encompasses teaching ethics at the beginning of the undergraduate medical curriculum. The study was planned to assess the knowledge and awareness of ethics among first-year undergraduate medical students at the beginning of the foundation course and after 40h of ethics training during the course.

Materials and Methods:
A standard 35-item questionnaire was administered to the first-year medical students at the beginning of the foundation course and after 40h of ethics training/teaching scattered throughout the foundation course. No personal information was recorded on the questionnaire to ensure the confidentiality and anonymity of participants.

Results:
There was a significant increase in the knowledge regarding some of the items in the questionnaire, such as “patient’s wishes must always be adhered to,” “if the patient refuses to be treated on religious grounds, they should be instructed to find another doctor.” Similarly, there was an improvement in the students’ knowledge of the practice of ethics. The students generally agreed that an awareness of ethics is important and should be an integral part of the MBBS curriculum.

Conclusion:
To prevent ethical erosion, ethics education should be introduced early during the undergraduate years, and continuous reinforcement is vital. We should strive to promote discussions about real occurrences directly involving students.
Novel method of tuboplasty using a thread stent
Authors: Palnitkar Anuradha , Palnitkar Devdatt 
Published: October 2021

Background:
Women who have undergone tubectomy for sterilization seek reversal of sterilization for various reasons. The success rate of the traditional method used for recanalization has been compared to our novel method of using a stent.

Objective:
The aim of this article is to evaluate the success rate of a novel method of tuboplasty using a threaded stent.

Materials and Methods:
Twenty-one tuboplasty surgeries for reversal of sterilization done at our center were reviewed. All the patients underwent open abdominal tuboplasty using 4× Loupes for magnification. 6-0 Prolene (Johnson & Johnson) suture was used for tubotubal anastomosis with seromuscular sutures. In 11 patients operated on after the year 2010, a 1-0 Ethilon (Johnson & Johnson) thread was used as a “stent.” Before the year 2010, we used to do the anastomosis similarly but without a stent. Eight such patients operated upon before 2010 without stent were evaluated. Two patients operated upon after 2010, in whom the stent could not be placed satisfactorily, were also included in this group of unstented patients.

Results:
Of the 11 patients who could be stented successfully, 8 (72.7%) conceived a uterine pregnancy. Two patients (18.2%) from the stented group did not conceive. From the group of patients who were not stented or could not be stented (n = 10), only two (20%) conceived.

Conclusion:
Our novel method of tuboplasty using a thread stent can improve the pregnancy rate to 72.7%.
Cost of medical management of patients in intensive care unit in a tertiary care teaching hospital, Pune, India
Authors: Mathew Achsah Anna , Karsiya Jainam Narendra , Patel Neel Kiran , Limbachiya Dharmik Anil , Shah Jignesh Navinchandra , Pawar Atmaram P. , Deshpande Prasanna R. 
Published: October 2021

Aims and Objectives:
The aim of this study was to assess the cost of illness of the patients admitted to the intensive care unit (ICU).

Materials and Methods:
A prospective observational study was conducted on patients admitted and discharged from ICU above 18 years of any medical illness for 6 months in ICU in a tertiary care teaching hospital, Pune. Data such as demographic details, diagnosis, disease class, cost of drug therapy, and medical care cost were obtained. The cost was analyzed using the bottom-up method and statistical analysis of data was done using Pearson’s correlation coefficient and Mann–Whitney U test.

Results:
Of 400 patients, the average age was 54.27 years with a length of stay of 3.69 days and mortality rate of 12.25%. The average total cost per patient accounted for Rs. 52,840 and the per day cost was Rs. 14,319. Amongst various diagnoses, the cost incurred in alcoholic liver disease (ALD) accounted for Rs. 75,060 of the total cost, whereas the average per day cost observed in myocardial infarction (MI) was Rs. 15,495. The cost of drug therapy per patient was Rs. 5204.33 and total drug therapy accounted for 12.08%. The average number of drugs prescribed per patient was 8.44. Antimicrobial costs were observed as 28% of the total cost. The cost of antimicrobials was Rs. 1473 per patient. Medical care costs, including consultant and investigation charges per patient, were found to be Rs. 632 and Rs. 6861, respectively.

Conclusion:
The study reveals that ICU bed charges, miscellaneous charges, and drug therapy costs have more contribution to the direct medical cost of hospitalization.
The Effect of Training and Provision of Logistic Support on Disease Surveillance and Notification System in Private Health Facilities in Enugu State, Nigeria
Authors: Ibiok Ntat Charles , Aniwada Elias Chikee , Ossai Edmund Ndudi , Nwobi Emmanuel Amechi , Uzochukwu Benjamin S. C. 
Published: October 2021

Introduction:
Rapid notification of infectious diseases is essential for prompt public health actions and monitoring disease trends at local, state and national levels. Disease surveillance is the backbone of Health Management Information system (HMIS). The study assessed the effect of training and provision of IDSR forms on disease surveillance and response in selected private hospitals in Enugu state.

Methodology:
The study was a quasi-experimental study that compared the study and control groups “before and after” an intervention (training and provision of IDSR forms). The intervention group received training and supplies if IDSR forms while the control group did not. A multistage sampling technique was used to select 400 participants from one hundred and four private hospitals in eight selected LGAs in Enugu East and Enugu North Senatorial Districts. Baseline data were collected followed by intervention. After six months waiting period post-intervention data were collected. A Questionnaire and observational checklist were used. Pearson and McNemar chi-square tests were employed. The level of statistical significance was set at p < 0.005.

Result:
At baseline, most knowledge and practice variables were poor (< 50%). The mean score of knowledge and practice between the groups at baseline was not significant (knowledge p=0.203 and practice p= 0.138). However, six months post-intervention there were significant increases in proportion for both knowledge and practice for study (McNemarχ2 p < 0.001) but not so control group. There was no statistically significant association of knowledge and practice with socio-demographic characteristics for both groups.

Conclusion:
Training of HCWs and provision of IDSR forms caused significant improvement in both knowledge and practice of disease notification and reporting in the private healthcare sector.
Antepartum Depression among Women Attending Antenatal Clinic in a Nigerian Teaching Hospital
Authors: Sulyman Dauda , Aminu Muhammad Baffah , Ayanda Kazeem Ayinda , Dattijo Lamaran Makama 
Published: October 2021

Background:
Antepartum depression is a clinical depression occurring at any stage of pregnancy. The cause of antepartum depression might be a combination of hormonal changes and psychological factors. Antepartum depression can affect the course and outcome of pregnancy.

Objectives:
This study aimed to find the prevalence rate of antepartum depression and its determinant among women attending antenatal clinics.

Methodology:
The study was a cross-sectional questionnaire-based survey conducted among pregnant women at Abubakar Tafawa Balewa University Teaching Hospital, Bauchi, Nigeria. With the use of the Edinburgh Postnatal Depression Scale, depression was screened among the respondents with the cutoff point of 13.

Results:
The study comprised 320 pregnant women. The majority (64.4%) of the respondents were below the age of 30 years. The predominant religion was Islam (58.7%). Twenty of the respondents were unmarried (6.2%). Only 2.5% had no formal education. Eighty-five of the respondents reported not having adequate support from their partners. Only 30% of the respondents were in their first pregnancy, and more than 66% were in their third trimesters. The prevalence rate of severe depression was 18.4%. Factors associated with antepartum depression were lack of support, first pregnancy, and third trimesters.

Conclusion:
This study found that a sizeable proportion of pregnant women attending antenatal clinics suffered from depression and highlighted factors associated with this. There is a need for screening for depression among pregnant women.
Analgesic and Opioid Sparing Effects of Preoperative Thoracic Paravertebral Block
Authors: Okoye Nnaemeka Ugonna , Majekodunmi Adetinuwe A. , Ilori Iniabasi U. 
Published: October 2021

Background:
Various regional anaesthetic techniques are used for post-mastectomy pain relief; however, thoracic paravertebral block (TPVB) has shown some advantages over other methods. This study sought to demonstrate the post-operative benefit of pre-operative TPVB in patients scheduled for simple mastectomy.

Methods:
The study was carried out on 60 adult female patients with the American Society of Anesthesiologists physical status Class I to III scheduled for unilateral mastectomy. Pre-operatively, a nerve stimulator was used to locate the paravertebral space thereafter bupivacaine with adrenaline or saline was injected into the space. Post-operatively, intravenous morphine patient controlled analgesia was commenced in the two groups for 24 h after the surgery. In addition, intravenous paracetamol 15 mg/kg was administered 6 hourly for 24 h in both groups.

Results:
The 24 h morphine consumption was significantly reduced in the bupivacaine group compared to the control group (P = 0.000). The Numerical pain rating score was significantly lower in the bupivacaine group than in the control group in the 1st 6 h; P = 0.001. The time to first request for analgesia was significantly longer in the bupivacaine group than the control group (P = 0.000). Nausea was the major side effect detected and this was significantly higher in the control group (P = 0.024). The morphine sparing effect was 65.7% in the bupivacaine group.

Conclusion:
The study showed that bupivacaine-based TPVB provided an effective post-operative analgesic and opioid-sparing effect for simple mastectomy when compared with a saline-based control group that received only intravenous morphine patient controlled analgesia and paracetamol.
Role of Histopathology in Diagnosis of Ovarian Neoplasms
Authors: Chakrabarti Preeti Rihal , Chattopadhyay Monideepa , Gon Sonia , Banik Trisha 
Published: October 2021

Context:
Ovarian tumours are known to be diverse biologically, varying from non-malignant to malignant tumours having implication on course of the management and prognosis. To address the paucity of such study on ovarian neoplasm from our region of West Bengal, we planned and executed this study. The aim of the study was to analyse the distribution of various ovarian tumours and classify them according to the biological behaviour, age, laterality, and mode of the presentation.

Setting and Design:
It was a retrospective study done in a tertiary care center of Kolkata, India.

Methodology:
A retrospective data of 4 years comprising 84 cases were included in the study from January 2016 to December 2019. All the slides were retrieved from the archives and re-evaluated and cross-checked with patients' clinical history, demographic, and macroscopic findings.

Results:
Out of these 84 tumours, maximum cases were of surface epithelial neoplasms (69%) followed by germ cell tumours (26.1%). Age interval of 19–40 years accounted for the highest number of individuals with equal predominance of both sites of the ovary. Serous cyst adenocarcinoma was the most common malignant tumour.

Conclusion:
Histological examination remains the mainstay in the early diagnosis of ovarian tumours and facilitates timely appropriate management of patients, and hence, reduces overall mortality in women.
Variant Neurovascular Relations of the Sphenoid Sinus in Adult Nigerians
Authors: Ominde Beryl Shitandi , Igbigbi Patrick Sunday 
Published: October 2021

Background:
With the advent of endoscopic sinus surgery, the variant neurovascular relations of the sphenoid sinus are important to surgeons to minimise the iatrogenic complications. This study elucidates the variant neurovascular relations of the sphenoid sinus in adult Nigerians.

Materials and Methods:
This study was conducted at the Radiology Department of Delta State University Teaching Hospital after institutional approval. Brain computed tomography images of 336 patients, aged ≥20 years and spanning over 5 years' duration were utilised. We evaluated the sphenoid sinus for protrusion and dehiscence of neurovascular structures bilaterally. The position of the optic nerve in relation to the sinus was classified from Type 0–4. The Statistical Package for the Social Sciences software version 23 was used for the data analysis. The Chi-square test was used to probe for the association between the variants with regard to side and gender. P < 0.05 was considered statistically significant.

Results:
Dehiscence and protrusion of the internal carotid artery (ICA) occurred in 34, 10.1% and 83, 24.7% patients correspondingly. The dehiscence of optic, maxillary and Vidian nerves was (26, 7.7%), (60, 17.9%), and (53, 15.8%), whereas the frequency of their protrusion was (50, 14.9%), (76, 22.6%) and (87, 25.9%), respectively. All these variants except the ICA and maxillary nerve dehiscence showed a significant association with the side of occurrence (P = 0.001). Out of the 672 optic canals evaluated bilaterally, a preponderance of Type I (534, 79.5%) was observed followed by II (96, 14.3%), IV (35,5.2%), III (7, 1.0%) and Type 0 (0, 0%).

Conclusion:
Our study has shown that the neurovascular relations of the sphenoid sinus vary from previously documented reports, thus confirming the need for pre-operative evaluation.