bluuebunny/crossref_metadata_2025_split huggingface dataset:
L’organisation communautaire au sein du service public québécois
Authors: Berthiaume Annabelle , Mariette Audrey 
Published: November 2024

Cet article porte sur l’émergence, la structuration et les pratiques d’un groupe professionnel, celui des organisateur·rices communautaires (OC) au sein du réseau public de la santé et des services sociaux au Québec. S’appuyant sur des pratiques issues des mouvements sociaux, le segment étatisé de ce groupe professionnel s’est adapté tout en participant aux évolutions de l’action publique pour définir sa position et maintenir le sens de son travail au service des habitant·es des quartiers populaires et de la lutte contre les inégalités sociales. À partir du cas d’un OC ayant exercé dans un quartier populaire de Montréal de 1976 à 2012, nous revenons sur les incertitudes et les ambivalences qui ont accompagné la professionnalisation du groupe des OC au sein du service public, entre approche contestataire et approche pragmatique de l’action publique. L’étude de cette trajectoire singulière insérée dans la trajectoire collective du groupe professionnel éclaire les transformations de l’État social pour montrer comment les tensions constitutives du métier et les pratiques professionnelles entre action collective et action publique se reconfigurent.
Bilateral lower limb weakness due to transverse myelitis as a first presentation of ankylosing spondylitis
Authors: Salim Firas , Abuhashem Shadi , Nassar Osayd , Alfroukh Khadeejeh , Alzatari Ibrahim , Smerat Mohammad I. , Atawnah Saed I. 
Published: November 2024

Abstract:
The occurrence of transverse myelitis (TM) in ankylosing spondylitis (AS) patients is a rarely reported event with only a few reports of similar cases in existing literature. When faced with a patient with TM, attention should be focused on determining the cause. AS should be kept in mind as a possible etiology. We report the case of a 58-year-old female patient who presented at Al-Ahli Hospital in Palestine, with a 3-day history of lower limb weakness, preceded by a 1-month history of lower back pain with radiation to lower limbs. Based on clinical findings and a comprehensive diagnostic work-up, the patient was diagnosed with TM along with AS. Steroid therapy was started, with pulse therapy having minimal effect. Due to the poor response to steroid therapy, plasmapheresis was done with a good response. After careful consideration, our patient was discharged on low-dose oral glucocorticoids for her TM, and methotrexate for her AS, with close follow-up by a neurologist and a rheumatologist.
The frequency of suprascapular neuropathy in Egyptian patients with chronic shoulder pain, focusing on the impact of manual labor
Authors: Saif Dalia Salah , Serag Dina Mamdoh , Elaraby Hager Abd-Elmegeed , El Ghanam Mohamed M. , Soliman Samar Gaber 
Published: November 2024

Abstract:

CONTEXT:
The suprascapular nerve (SSN) arises from the upper trunk of the brachial plexus. It provides sensory branches to the shoulder joints as well as motor branches to the infraspinatus (IS) and supraspinatus (SS) muscles. Although the entrapment of the SSN is uncommon, it occurs at variant locations along its pathway and is manifested by muscle atrophy, weakness, and shoulder pain. This study aimed to determine the frequency of SSN affection in Egyptian patients with chronic nonspecific shoulder pain, with a particular emphasis on the variations in this frequency between manual and nonmanual workers.

PATIENTS AND METHODS:
A cross-sectional analytic study comprised 174 patients with chronic nonspecific shoulder pain. Patients were classified into manual worker and nonmanual worker groups. All participants underwent clinical, radiological, and electrophysiological studies involving motor nerve conduction studies of the SSN and electromyography of SS and IS muscles.

RESULTS:
Across all study patients, the frequency of SSN affection was 21.8%, whereas it was 35.9% in manual workers, compared to 6.1% in nonmanual workers, as determined by clinical and electrophysiological studies. Significant differences in the clinical and electrophysiological findings of SSN entrapment were found between the two groups.

CONCLUSION:
Suprascapular neuropathy, although rare, is increasingly recognized as a source of shoulder discomfort and pain resulting from nerve entrapment, especially in those who engage in overhead activities. Therefore, early detection, accurate localization, and effective treatment are crucial to prevent muscle atrophy and wasting.
Thyroid dysfunction and autoantibodies in rheumatoid arthritis patients at King Saud Medical City: A retrospective cohort study
Authors: Hegazy Asmaa , Dher Shatha Bin , Aleidan Fahad , Alhindi Raghad , Alamri Mohammed M. , Alshammari Saitah 
Published: November 2024

Abstract:

BACKGROUND:
Autoimmune thyroid diseases often coexist with conditions such as Sjögren’s syndrome and rheumatoid arthritis (RA). Studies have shown that patients with RA are at an increased risk of thyroid dysfunction. Studies conducted in Egypt and Jeddah have demonstrated a higher prevalence of thyroid dysfunction in patients with RA. This study aimed to determine the prevalence of thyroid dysfunction and its characteristics in patients with RA treated at a single center in Saudi Arabia.

METHODS:
This was a retrospective cohort study conducted at King Saud Medical City, Riyadh, Saudi Arabia. All patients with RA who qualified for the American Rheumatism Association criteria between 2016 and 2021 were eligible for inclusion. All patients underwent clinical examination and tests for thyroid function and RA-specific autoantibodies. The primary outcome was the presence or absence of thyroid disorders.

RESULTS:
A total of 158 RA patients were included. Eighty-five patients (53.8%) were seropositive, including 65 (41.1%) positive for rheumatoid factor and 58 (36.7%) positive for anti–citrullinated protein antibody. Erythrocyte sedimentation rate was elevated in 108 (72%) patients and 28 (19%) patients had significant Disease Activity Score (DAS 28). Vitamin D deficiency was observed in 100 patients (66.7%). Sixteen percent of patients in this cohort had hypothyroidism and 4.2% had hyperthyroidism. Vitamin D deficiency was associated with hyperthyroidism (2.1% vs. 8.9%, P = 0.048). Vitamin D deficiency was not significantly linked to seropositive RA (50% vs. 60%, P = 0.247) but was significantly associated with higher DAS 28 (15% vs. 30%, P = 0.030).

CONCLUSION:
Our study provides insights into thyroid patterns in Saudi Arabian patients with RA, highlighting the role of Vitamin D in thyroid disorders and disease activity.

CATEGORIES: Internal Medicine, Rheumatology.
Early Childhood Caries: Expectant Mothers’ Knowledge, Attitude, and Willingness to Treatment
Authors: Venugopal Malini , Alex Vinitha , Khosla Ektah , Abraham K. Korath , James Arun Roy , Thenumkal Elsa 
Published: November 2024

Abstract

Background:
Early childhood caries (ECC) is one of the most challenging diseases in childhood, which may begin as soon as teeth erupt into the oral cavity. The treatment is invasive, causing physical as well as mental stress not only among children and parents but also among dentists. ECC also places a heavy financial burden on the community. Hence, preventive treatment is considered to be of utmost importance. This study carried out in Kerala aimed to assess expectant mothers’ knowledge, attitude, and willingness to treat early childhood caries.

Materials and Methods:
A cross-sectional survey was conducted among 150 expectant mothers visiting the outpatient department of a tertiary care hospital. A validated 28-item questionnaire was administered to know mothers’ awareness of the importance of primary teeth and their attitude, willingness, and readiness to initiate preventive oral healthcare for their children.

Results:
The result showed that around 89.3% were unaware of when to begin tooth brushing, around 78% had no idea that sharing utensils and frequent kissing can transmit cariogenic bacteria, and almost 81.3% of mothers were unaware of the fact that frequent snacking increases the probability of caries. About 82.7% preferred pedodontist for treatment.

Conclusion:
Expectant mothers have inadequate knowledge about oral health. The study showed that employed mothers had better oral hygiene knowledge than unemployed mothers. However, educated mothers were willing to prevent this through early identification and regular checkups.
Clinical Significance: Kerala is a state with almost 100% literacy, but expectant mothers still have inadequate knowledge about the importance of oral health. The most common barrier to poor oral health in children is insufficient information among mothers about practices for preventing dental healthcare-associated problems. Awareness about dental health must be started during pregnancy to initiate prevention as early as possible. Healthcare information provided to expectant mothers can effectively prevent ECC, and education programs targeted at them will have a higher chance of success. Steps to include awareness programs among medical care providers who are in regular contact with the expectant mother are of paramount importance.
Understanding the Roles of Religion in Nursing Practice as a Prescriptive Instrument for High-Quality Faith-Based Healthcare
Authors: Olorunfemi Olaolorunpo , Agbaje Oluwapamilerinayo Cynthia , Abiodun Oluwaseun Oluwafunmilayo , Ayeni Bamidele Abiodun , Osunde Rosemary Ngozi 
Published: November 2024

Abstract
Religion is the patient’s belief in a higher power. This power could have a significant impact on the care provided by nurses. Therefore, it is important to examine the role of religion in providing holistic and faith-based nursing care. The objective of this study is to assess the roles of religion in nursing practice. This study reviewed previous works of literature and screened for eligibility, with the search years of 2018–2024 to capture the identified variables in the review objectives. In our literature search, we discovered various ways in which religion intersects with nursing practice, shaping attitudes, beliefs, decision-making processes, and holistic patient care through transcultural nursing theory. In conclusion, we discovered that religion has a diverse and significant role in nursing practice, influencing both professional aspects of caregiving and patient well-being; it brings strength, hope, comfort, and resilience. All of these help patients cope with anxiety, stress, and depression while improving the overall health outcomes. It is therefore essential that nurses acquire at least a basic knowledge of the most common religions to provide holistic care that meets their patients’ needs. We also encourage nurses to work following their clients’ religious beliefs and not discriminate when they differ from their own.
Surgical Management of Penoscrotal Filariasis by Reconstructive Penoscrotoplasty: An Experience from a Tertiary Healthcare Centre
Authors: Sharma Aditya , Khanna Ritika , Mishra Shashi Prakash , Meena Ram Niwas , Khanna Seema , Khanna Rahul 
Published: November 2024

Abstract
Chronic lymphedema has a number of etiological causes that affect the lymphatic drainage system. It is characterized by the gradual buildup of protein-rich fluid in the subcutaneous tissue. Any of the body components may be involved, and the causes may vary from congenital to acquired. Lymphedema and subcutaneous tissue thickening are characteristics of external genital elephantiasis. As a result, the skin has a pachyderm-like look. For the sufferer, this pathology is invalidating. Often, reconstructive surgery is the only option for restoring the external genitalia’s appearance and functionality. We report a case series of patients who presented with giant penoscrotal filariasis and were successfully managed with reconstructive penoscrotoplasty.
Estimation of Undiagnosed Diabetes and Pre-diabetes in People 45–75 Years in Two Blocks of Himachal Pradesh, India: A Cross-sectional Study
Authors: Bhardwaj Ashok , Kumar Sanjay , Singh Mitasha , Goel Chirag 
Published: November 2024

Abstract

Background:
As per the International Diabetes Federation guidelines and American Diabetic Association guidelines, all people above 45 and <75 years should be regularly tested for undiagnosed diabetes.

Objective:
We aimed to estimate the prevalence of undiagnosed diabetes and pre-diabetes in the population aged 45–75 years using fasting plasma glucose (FPG), oral glucose tolerance test (OGTT), and glycated hemoglobin (HbA1c).

Materials and Methods:
An observational cross-sectional study was conducted at district Hamirpur and district Una of Himachal Pradesh on 600 adults 45–75 years of age. A community-based screening was conducted using a questionnaire with symptoms suggestive of diabetes and other non-communicable diseases such as hypertensions and stroke. Already diagnosed diabetics were excluded from the second phase of the study where all patients positive on screening were invited for laboratory investigations to confirm the diabetic status. Diabetes and pre-diabetes prevalence was calculated using fasting blood glucose (FBS), OGTT, and HbA1c criteria of the World Health Organization individually.

Results:
Using FBS, 21.7% were found to be pre-diabetic and 15.5% were diabetic. Using OGTT on the same population, 19.7% were labeled as diabetic and 48.2% were impaired glucose-tolerant.

Conclusion:
The prevalence of only diabetes was highest on OGTT and lowest using FPG.
Myoclonic Jerks in an Ex-Preterm Undergoing Hernia Surgery Under Combined Spinal Caudal Block: Is It Time to Revisit the Test Dose?
Authors: Kumar Lakshmi , Padmanabhan Neethu , Thomas Dimple Elina , Pillai Pramod R. 
Published: November 2024

Abstract
Myoclonic jerks, while often benign, can indicate underlying issues such as inadvertent intrathecal or intravascular injection of the local anesthetic. In preterm infants, whose physiological responses are often more unpredictable and sensitive, the risk of complications from regional anesthesia may be heightened. We present the management of a possible local anesthetic systemic toxicity in an ex-preterm infant scheduled for an elective left inguinal herniotomy.
Hip Arthroplasty in an Acute-On-Chronic Liver Failure Patient Followed by Early Live Donor Liver Transplant
Authors: Aravind S. , Thilak Jai , Valsan Arun , George Mathew , Gundavalli Koushik , Sadasivan Shine , Sudhindran S. 
Published: November 2024

Abstract
An acute-on-chronic liver disease patient, during workup for liver transplant, presented with a transcervical neck of femur fracture following a trivial trauma. High risks were associated with performing the surgery under general anesthesia, coagulation failure, and risks of infection, resulting in intraoperative or post-operative mortality. Addressing each of these risk factors, the patient underwent a cemented bipolar hemiarthroplasty under regional nerve block, followed by early live donor liver transplantation with an uneventful post-op recovery and currently mobilizing without support. In the case of patients with acute-on-chronic liver failure, identifying the risk factors and complications that are expected perioperatively and intraoperatively and further planning the management by a multidisciplinary team approach can result in improved outcomes.
Comparison of Intra-operative Specimen Imaging in Breast Surgery with MOZART® 3D Specimen Tomosynthesis System versus Conventional Specimen Radiography: An Early Institutional Experience
Authors: Basu Pallavi , Mok Chi Wei 
Published: November 2024

Abstract

Context:
Traditionally, breast specimen radiography is performed in a radiology unit (conventional specimen radiography, CSR). It has been shown that intra-operative specimen imaging allows for satisfactory assessment and shorter total operative time.

Aim:
Evaluate the performance and safety of intra-operative specimen radiography (ISR) compared to CSR.

Settings and Design:
This observational study included all patients who underwent breast-conserving surgery for breast cancer or excision of other breast lesions with ISR between November 2021 and June 2022 in our institution. Both palpable and non-palpable breast lesions requiring pre-operative localisation were included.

Materials and Methods:
ISR was performed using the MOZART® 3D Specimen Tomosynthesis System (Kubtec Medical Imaging, Stratford, CT, USA) by breast surgeons, after which specimens were sent to radiology for CSR. The primary aim was to assess the time taken for evaluation of the adequacy of excision via ISR compared to CSR (performance) and whether assessments by surgeons were concordant with those by radiologists (safety).

Statistical Analysis:
A P value of <0.05 was taken to be statistically significant.

Results:
Thirty-two specimens were assessed from 30 patients. The mean time taken for the final image to be ready for viewing was 1.9 min in ISR and 14.4 min in CSR (P <0.05). Mean time taken to make a decision on the adequacy of surgery was 1.8 min in ISR and 25.4 min in CSR (P < 0.05). The short time taken for decision with a mean of 1.8 min (range 0–4 min) across all cases showed the ease of use with the ISR system. Both surgeons and radiologists were able to identify lesions of interest within specimens with 100% concordance.

Conclusion:
Intra-operative specimen imaging assessment by surgeons using ISR is a safe and reliable technique with a shorter total operative time.
Evaluating the Impact of Elective Endotracheal Tube Replacement on Postoperative Outcomes in Esophageal Atresia: A STROBE-guided Study
Authors: Nandan Ruchira , Singh Ram Badan , Bhalekar Arvind , Marripati Bhanumurthy Kaushik , Gangopadhyay Ajay Narayan , Pandey Vaibhav 
Published: November 2024

ABSTRACT

Background:
Elective ventilation and paralysis have been shown to decrease the anastomosis-related complications following primary repair of esophageal atresia (EA). Repeated endotracheal tube (ETT) block and replacement can increase these complications. We evaluated the results of our strategy of electively changing the ETT just before shifting the patient to the postoperative ward for elective ventilation.

Materials and Methods:
A retrospective study was conducted using the case records of patients from July 2015 to February 2024 including all the patients of EA with tracheoesophageal fistula who underwent primary repair with end-to-end esophageal anastomosis. The patients were divided into two groups Group A: ETT was changed and Group B: ETT was not changed immediately before shifting. The groups were compared for anastomotic leak and ETT tube block in the first 48 h.

Results:
Ninety-one patients were included in the study, 36 in Group A and 55 in Group B. Elective replacement of ETT decreased the tube block rates in the first 48 h following surgery (P = 0.032). Tension in the anastomosis was associated with a higher leak rate. The leak was present in 58.3% and 3.6% in cases with and without tension in the anastomosis (P = 0.001). Overall, the anastomotic leak was similar in both groups. In the subgroup of patients with anastomosis under tension, the rate of anastomotic leak was higher in patients with ETT block (P = 0.028).

Conclusion:
Elective replacement of EET decreases the tube block rates and anastomotic leak rates in cases with anastomosis under tension.
Wilms’ Tumor – An Audit
Authors: Sarin Yogesh Kumar , Losu Pute U. , Nangia Anita 
Published: November 2024

ABSTRACT

Background and Aims:
Outcome analysis of patients with Wilms’ tumors (WT) is presented.

Materials and Methods:
A retrospective analysis of 23 children having WT managed by a single surgeon over 3 years (2021–2024) using the International Society of Paediatric Oncology Umbrella protocol was done.

Results:
The median age at presentation was 36 months; 32 months and 24 months for the unilateral WT (uWT) (n = 19) and bilateral WT (bWT) (n = 4), respectively. M: F ratio was 2.3: 1. WTs were localized in 19 (uWT-16; bWT-3) and metastatic in 4 (uWT-3; bWT-1) patients. Core-needle biopsy was done in 22 patients (26 renal units). Pre-therapy contrast-enhanced computed tomography volumetry (n = 20) showed a median tumor volume of 1023 ml (range: 47–2680 ml). Post-neoadjuvant chemotherapy (NACT) median tumor burden (n = 19) was 612 ml (range 59–3775 ml). Post-NACT, tumor volume decreased in 11/18 patients but increased in seven patients. NACT was avoided in one neonate. Nephroureterectomy (including one with excision of bladder cuff) and nephron-sparing surgery were done in 17 and 10 renal units including 3 with multifocal WT, respectively. Risk stratification was intermediate in 21 and High in 2. Overall staging in 19 uWT included Stage I-7, Stage II-5, Stage III-4, and Stage IV-3 (local staging-stage I in 1 and stage II in 2). Local staging in 8 renal units with bWT was Stage I in 7 and II in 1. One stage IV uWT had bilateral pulmonary metastatectomy. Adjuvant chemotherapy has been completed in 18 patients; two patients are still on adjuvant chemotherapy; flank radiation was administered in six patients. Three patients with synchronous bWT died; two due to acute kidney injury in the immediate postoperative period and one with metastatic disease who had abandoned adjuvant chemotherapy after the 1st cycle. Another patient died of a huge metachronous tumor in the contralateral kidney after a year of completion of therapy. One patient had successful multimodality treatment of local relapse with liver metastasis. 1-year overall and event-free survivals are 84% and 76%, respectively.

Conclusions:
Excellent short-term results for localized uWT from a center in a low-middle-income country are reported.
BANKRUPTCY RISK AND SHARE PRICES: A CASE STUDY ON ENERGY COMPANIES IN KUWAIT
Authors: AlAli Musaed S. , AlAskar Ibraheem T. , AlForaih Eman O. 
Published: November 2024

<p>This study aims to investigate how investors' perceptions of risk impact the stock prices of energy companies listed on the Kuwait Stock Exchange (KSE) from 2016 to 2023. Investors' belief in the future financial stability of the companies they invest in influences their risk perception. Therefore, if investors hold pessimistic views, they will decrease their investment in these companies, causing share prices to drop, and vice versa. The Zmijewski x-score model is utilized in this study as a measure of risk to assess the financial stability of Kuwaiti energy companies and its impact on their stock prices. The study employs ordinary least square regression (OLS) to analyze the correlation between the x-score and share prices. Results from this research indicated that there was no statistically significant relation between Zmijewski's x-score and stock price and that investors look at other factors when choosing their investments. This is evident because the company with the greatest bankruptcy risk in the following two years also had the second-highest share price.</p><p> </p><p><strong>JEL: </strong>G1, G4, M21</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/soc/0699/a.php" alt="Hit counter" /></p>