bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care physicians’ knowledge and attitudes about obesity, adherence to treatment guidelines and its’ association with confidence to treat obesity at the Saudi Ministry of Interior primary health care centers
Authors: Al Saud Lama Mohammed , Altowairqi Saad Ebrahem , Showail Anwar Ali , Alzahrani Bader Saad , Arnous Maha M. , Alsuhaibani Raya Mohammed 
Published: September 2024

ABSTRACT

Background and Aim:
Many primary care physicians (PCPs) believed that managing overweight and obesity is essential to their jobs, however, many believe that they were doing it ineffectively, unsatisfying, and had negative attitudes. We conducted this study to explore the knowledge, attitudes and adherence to obesity management guidelines, identify potential barriers that may prevent adherence of PCPs to obesity treatment guidelines.

Methods:
We conducted this cross-sectional study and conducted a questionnaire sent via email to all PCPs in the Ministry of Interior centers in Riyadh, Al-Kharj, AlQassim, Wadi Ad Dawasir, Hail and Tabuk in Saudi Arabia.

Results:
A total of 119 PCPs participated in the survey, 61 (51.3%) males and 58 (48.7%) females. All respondents (n = 119, 100%) answered correctly that obesity is a disease. Of PCPs surveyed, genetics accounted for 75.6% of the responses as the cause of obesity. 79.8% believed that the best way for patients with obesity to lose weight was to engage in regular physical activity. The majority of PCPs (87.4%) thought that treating obesity should be a top priority, and 88.2% would typically recommend obesity therapy to their patients. Around 68.9% of PCPs thought that it’s their patients’ responsibility to lose weight. The majority will recommend obesity treatment and 75.6% would talk to their patients about weight concerns, while 60.5% would refer their patients to obesity surgery. There was a positive significant association between higher knowledge and better attitude and better adherence to treatment guidelines. More experienced PCPs were more confident. The most common perceived barrier was the patients’ lack of desire to follow obesity treatment.

Conclusion:
Primary care clinics and PCPs play a crucial role in diagnosing and treating patients with obesity, according to Ministry of Health guidelines on the prevention and management of obesity. PCPs must not only acknowledge obesity as a chronic illness and the possible long-term consequences it may cause, but also provide comprehensive, multi-component interventions that include lifestyle changes, medication, and appropriate referrals for bariatric surgery when needed. Healthcare professionals must form a cooperative relationship with obese patients to ensure that the patients follow treatment protocols.
The Correlation of Global Burden of Vision Impairment and Ambient Atmospheric Fine Particulate Matter
Authors: Abdolalizadeh Parya , Falavarjani Khalil Ghasemi 
Published: September 2024

Abstract

Purpose:
To assess the correlation between the worldwide burden of vision impairment (VI) and fine particulate matter (PM) 2.5.

Methods:
In this retrospective cross-sectional study, global and national prevalence and disability-adjusted lost year (DALY) numbers and rates of total VI, glaucoma, cataract, and age-related macular degeneration (AMD) were obtained from the Global Burden of Disease database. The global and national levels of PM2.5 levels were also extracted. The main outcome measures were the correlation of PM2.5 levels with total VI and three ocular diseases in different age, sex, and socioeconomic subgroups.

Results:
In 2019, the worldwide prevalence of total VI and exposure level of PM2.5 was 9.6% (95% uncertainty interval: 8.0–11.3) and 42.5 μg/m3, respectively. The national age-standardized prevalence rates of total VI (r
p = 0.52, P < 0.001), glaucoma (r
p = 0.65, P < 0.001), AMD (r
p = 0.67, P < 0.001), and cataract (r
p = 0.44, P < 0.001) have a positive correlation with PM2.5 levels. In addition, the national age-standardized DALY rates of total VI (r
p = 0.62, P < 0.001), glaucoma (r
p = 0.62, P < 0.001), AMD (r
p = 0.54, P < 0.001), and cataract (r
p = 0.45, P < 0.001) significantly correlated with PM2.5 levels. The correlations remained significant in different age, sex, and sociodemographic subgroups.

Conclusion:
National prevalence rates of VI and three major ocular diseases correlate significantly with PM2.5 exposure levels, worldwide.
The Effect of Early Posttrabeculectomy Bleb Leakage on Surgical Outcome: A Prospective Cohort Study
Authors: Yadgari Maryam , Yazdani Maryam Oraee , Karbasi Pantea , Naseripour Mahya , Shojaei Ahmad 
Published: September 2024

Purpose:
To evaluate the effect of early posttrabeculectomy bleb leakage on trabeculectomy surgery outcomes and success rate.

Methods:
The present prospective cohort study was conducted on 203 eyes of 203 patients who underwent trabeculectomy at Torfeh and Imam Hossein Medical Centers, Tehran, Iran, between 2016 and 2021. Patients were divided into two groups: those with early bleb leakage (within the 1st month of surgery) and those without bleb leakage. The success rate of surgery was compared 12, 18, and 24 months after surgery in the two groups. The average intraocular pressure (IOP) and the need for medications in patients 1, 3, 6, 9, 12, 18, and 24 months after the trabeculectomy were also compared.

Results:
Bleb leakage was detected in 33 eyes during the 1st month after a trabeculectomy (16.3%). The mean decrease in IOP in the group with leakage was significantly lower than in patients without leakage at 1, 6, 9, 12, 18, and 24 months after surgery (P < 0.05). The need for antiglaucoma medication was significantly higher among patients with bleb leakage at 3 months (P = 0.04) and 9 months (P = 0.047) after surgery (P < 0.05). The success rate at 12, 18, and 24 months after surgery was significantly lower in the group with leakage than the group without.

Conclusions:
The results of our study suggest that early posttrabeculectomy bleb leakage negatively impacts surgery success. Furthermore, IOP reduction was lower in patients with early leakage.
Cross-Sectional Study of Differences between Intraocular Pressure Measurements using Goldmann, iCare, and Air-Puff Tonometers and their Correlation with Central Corneal Thickness
Authors: Mandour Sameh Saad , Elframawy Ahmed , Murad Mohammad Moataz , Nage Sara Abd Elmegeed 
Published: September 2024

Abstract

Purpose:
To investigate the agreement between the Goldmann tonometer (GAT), the air-puff tonometer, and the iCare tonometer in intraocular pressure (IOP) evaluation as well as their association with central corneal thickness (CCT) in normal participants, glaucoma patients, and patients following refractive surgery.

Methods:
This is a cross-sectional study conducted on 204 eyes from 102 patients. The study consisted of three equal groups: group I (control group, n = 34), group II (glaucoma patients on medication, n = 34), and group III (refractive surgery patients, n = 34). All patients were subjected to examination (complete ocular examination, refraction, and IOP measurement).

Results:
A total of 102 participants were included in the study with both genders distributed equally. The mean ± standard deviation age was 44.12 ± 12.8 years in the control group while it was 46.29 ± 13.24 years in the glaucoma group and 40.68 ± 15.86 years in the refractive surgery group. Overall, there was a high correlation between the three methods. The mean IOP measured by GAT was 14.03 ± 3.43. The mean IOP measured by iCare was 15.16 ± 3.46. The mean IOP measured by air-puff was 16.66 ± 3.6. The iCare showed the most significant agreement with the GAT (intraclass correlation coefficient [ICC] 0.985, P > 0.05) and the mean difference in IOP between GAT and iCare was 1.1 (95% limits of agreement, −0.62–+2.85 mmHg). The mean difference in IOP between iCare and air-puff was 1.5 and it was 2.6 between GAT and air-puff. There were no significant differences in IOP measurements between GAT and iCare tonometer or between iCare tonometer and air-puff in all groups (P > 0.05). However, there were significant differences in IOP measurements between GAT and air-puff in all groups (P < 0.001). The ICC between all studied methods was strong (ICC > 0.92 for all). Regarding CCT, the mean CCT was 517.14 ± 29.82 μm. There were significant positive correlations between increasing CCT and increasing IOP by GAT, iCare, and air-puff tonometer among the three groups (P < 0.001).

Conclusions:
In conclusion, the iCare tonometer, specifically the iCare PRO RT model, is a reliable and efficient alternative instrument for assessing IOP. The IOP values obtained with the iCare PRO RT were found to be consistent with those obtained using the air-puff and GAT.
Low Ocular Perfusion Pressure Values at Rest and during Resistance Exercise in Offspring of Glaucoma Patients
Authors: Andrade Diana de Medeiros , Oliveira Jordane Benedito Vargas , Lacordia Marta Halfeld Ferrari Alves , Laterza Mateus Camaroti , Martinez Daniel Godoy 
Published: September 2024

Abstract

Purpose:
To compare the ocular perfusion pressure (OPP) response during physical exercise in individuals with and without a family history (FH+, FH−) of glaucoma.

Methods:
Thirty-four subjects, divided into FH+ and FH− groups, realized 3 min at rest, 3 min of isometric handgrip exercise at 30% of maximal voluntary contraction, followed by 3 min of recovery. Blood pressure (Dixtal® automatic device) and intraocular pressure (Goldmann applanation tonometer) were measured during rest, exercise, and recovery. The mean OPP (mOPP) was calculated.

Results:
In the FH+ group (17 subjects), baseline mOPP values were significantly lower than in the FH− group (17 subjects) (right eye: P < 0.001, left eye: P < 0.001, respectively). During exercise, both the FH+ and FH− groups showed a similar increase in mOPP in both eyes (right eye: FH+: 38 ± 4 mmHg vs. 51 ± 7 mmHg, FH−: 48 ± 5 mmHg vs. 57 ± 9 mmHg, P < 0.001; left eye: FH+: 39 ± 3 mmHg vs. 51 ± 7 mmHg; FH−: 46 ± 5 mmHg vs. 58 ± 8 mmHg, P < 0.001, respectively). However, the FH+ group maintained significantly lower mOPP values compared to the FH− group in the right and left eyes (group effect: P = 0.002, P = 0.002, respectively). The percentage of increase in mOPP in the FH+ group was greater compared to the FH− group during exercise (right eye: 34.1% ± 15.9% vs. 22.1% ± 13.2%, respectively; P = 0.025; left eye: 33.2% ± 17.7% vs. 22.4% ± 13.7%, respectively, P = 0.056).

Conclusions:
mOPP increased during physical exercise in both groups, but the FH+ group had lower absolute values. In addition, the FH+ group appears to demonstrate a higher percentage increase in mOPP compared to the FH− group.
Hypotony and Anterior Uveitis following Dual Therapy with Nivolumab and Ipilimumab for Metastatic Melanoma: A Case Report
Authors: Patil Nikhil S. , Dudok David , Khimdas Sarit 
Published: September 2024

Purpose:
To describe a rare case of hypotony and anterior uveitis following dual therapy with nivolumab and ipilimumab for metastatic melanoma.

Methods:
Case report.

Results:
Here, we present the case of a 64-year-old man taking nivolumab and ipilimumab dual therapy for BRAF+ (v-raf murine sarcoma viral oncogene homolog B1) metastatic melanoma. After treatment for 3 months, he presented to the ophthalmology clinic with bilateral intraocular pressures of 1 mmHg, bilateral keratic precipitates, cataracts, posterior synechiae, and anterior chamber inflammation. He improved with topical medications and the cessation of immunotherapy.

Conclusions:
Immunotherapies are a novel class of chemotherapy that has increased in prevalence for the treatment of numerous malignancies. There are many rare complications from these medications that are sparsely reported. Knowledge of ocular hypotony as a potential consequence of nivolumab and ipilimumab is important, particularly as it may arise months after treatment initiation and necessitate immunotherapy cessation.
Water-Drinking Test in Central Serous Chorioretinopathy
Authors: Goud Abhilash , Sahoo Niroj Kumar , Rasheed Mohammed Abdul , Singh Sumit Randhir , Ankireddy Samatha , Vupparaboina Kiran Kumar , Lupidi Marco , Chhablani Jay 
Published: September 2024

Purpose:
To evaluate choroidal changes in central serous chorioretinopathy (CSCR) patients after water-drinking test (WDT).

Methods:
This prospective study included treatment-naïve acute and chronic CSCR eyes and healthy controls. Intraocular pressure and optical coherence tomography measurements with choroidal vascular index (CVI) measurements were done at baseline. Patients were asked to drink 1 L of water, and tests were repeated at 15, 30, and 45 min.

Results:
Fifty-six eyes from 42 patients were enrolled. Choroidal area, luminal area, and stromal area were higher at baseline in eyes with acute CSCR compared to healthy controls. Chronic CSCR eyes showed an increase in choroidal area and stromal area and a decrease in the luminal area at 15 min. There was a significant decrease in CVI at 30 and 45 min in chronic CSCR and CVI at 45 min in fellow eyes of acute CSCR. Repeated-measures analysis of variance (ANOVA) showed a significant change in central macular thickness in acute CSCR, choroidal thickness in fellow eyes of acute CSCR, stromal area, and total choroidal area in chronic CSCR. Mixed model ANOVA showed that the change in various choroidal parameters seen had no interaction with the eye type.

Conclusion:
Although change in various parameters was seen in acute CSCR, chronic CSCR, and fellow eyes of acute CSCR following WDT, the change was not significantly different among the groups.
A Case of Infantile Cataract and Neonatal Hypoglycemia
Authors: Maamouri Rym , Ferchichi Molka , Chehida Amel Ben , Cheour Monia 
Published: September 2024

Purpose:
To describe a case of lamellar cataract in a child with a history of neonatal hypoglycemia and illustrate the importance of meticulous history-taking in children with cataracts, especially before planning surgery.

Methods:
A single case report.

Results:
A 7-year-old girl with a history of neonatal hypoglycemia and ketoacidosis with high suspicion of a primary defect in ketone body utilization who presented with bilateral progressive blurred vision. Her best-corrected visual acuity (BCVA) was 20/200 in her right eye (OD) and 20/400 in her left eye (OS). Slit-lamp examination showed the presence of bilateral dense lamellar cataract. Fundus examination was unremarkable in both eyes (OU). She underwent cataract surgery with intraocular lens implantation under general anesthesia without prolonged fasting. Final BCVA was 20/82 in OD and 20/63 in OS.

Conclusion:
Our aim through this case is to emphasize the importance to screen for episodes of hypoglycemic attacks in children with infantile cataracts.
Age-Related Macular Degeneration Prevalence and its Risk Factors in Iran: A Systematic Review and Meta-Analysis Study
Authors: Panahi Parsa , Kabir Ali , Falavarjani Khalil Ghasemi 
Published: September 2024

Abstract

Purpose:
To estimate the prevalence of age-related macular degeneration (AMD) and determine its risk factors in Iran.

Methods:
A comprehensive electronic search was conducted in PubMed, Scopus, Web of Science, and Google Scholar, with no restrictions on time or language of publication. Eleven studies meeting the eligibility criteria were included. Six studies with a total sample size of 9930 were included in the meta-analysis to calculate the overall prevalence of AMD in Iran. Meta-analysis was performed using Stata/MP version 15.0. Risk of bias assessment was carried out based on the Newcastle–Ottawa Scale.

Results:
All participants in the studies were over 40 years old. The pooled prevalence of AMD was estimated to be 9.9% (95% confidence interval [CI]: 6.3%–13.5%). After accounting for publication bias, this estimated decreased to 6.4% (95% CI: 4%–10.2%). Smoking (odds ratio [OR]: 1.781; 95% CI: 1.152–2.756), hypertension (HTN) (OR: 1.512; 95% CI: 1.119–2.044), diabetes mellitus (DM) (OR: 1.545; 95% CI: 1.088–2.194), and hyperlipidemia (OR: 1.512; 95% CI: 1.055–2.165) were identified as AMD risk factors.

Conclusion:
Based on the results of the present review, the prevalence of AMD in the Iranian population over 40 years of age is estimated to be 6.4%, and having a history of smoking, HTN, DM, and hyperlipidemia are identified as risk factors of AMD in Iran. Further original studies are needed to draw more accurate conclusions.
Dolutegravir-Associated Hyperglycemia in a Patient on Highly Active Antiretroviral Therapies
Authors: Adeyeye Abosede Grace , Adeyeye Victor Oladeji 
Published: September 2024

AbstractHighly active antiretroviral medications have been reported to cause hyperglycaemia in the literature especially the protease inhibitor. We however report a case of dolutegravir-associated hyperglycaemia which is an integrase strand transfer inhibitor.
Prevalence of Depression among Clinical Medical Students at a Tertiary Health Facility in Jos, North Central Nigeria
Authors: Ahangba Adamgbe Moses , Joshua Okpanachi , Misbah Naiya Zainab , Uzochukwu Chinweuba Francis , Dhikirullah Yusuf , Aboki Eko Anthony , Ibu Ogbaji Ferdinand 
Published: September 2024

Abstract

Introduction:
Depression is a common mental health disorder, affecting about 5% of adults worldwide. University students and medical students are at risk of coming down with depression and this may be so because of the academic work load and pressure that come with the learning environment in our tertiary health institutions. Other sociodemographic factors may also predispose these students to depression, thus affecting their academic performance and quality of life.

Aim:
The aim of this study is to assess the prevalence and severity of depression among clinical medical students at the College of Health Sciences (CHS), University of Jos, Nigeria using the Patient Health Questionnaire (PHQ-9).

Materials and Methods:
This was a cross-sectional study carried out on clinical medical students of the CHS, University of …, Nigeria. The students were selected through a multistage sampling technique and PHQ-9 questionnaire administered electronically. Data were analysed using the SPSS version 25.0. Depression was diagnosed when a student scored ≥10. The Chi-square test was used to analyse the sociodemographics and P < 0.05 was statistically significant.

Results:
A total of 247 students with a median age of 27.6 years responded to the study. The prevalence of depression was found to be 24.7%; more among fourth year clinical students and students within the age group of 20–24 years. Depression was statistically significant among females and most severe in them too.

Conclusion:
The above findings could stimulate institutional measures that are geared toward reducing the burden of depression among clinical medical students and this may help to improve their mental health and overall academic performance.
Anxiety and Depressive Symptoms among Discharged COVID-19 Patients from Isolation Centers in North-Central, Nigeria: A Cross-sectional Study
Authors: Tungchama Friday Philip , Gomerep Simji Samuel , Maigari Yusufu Taru , Akogun Margret , Bako Amabu Enoch , Nwoga Charles Nnemeka , Ajuma Ebiloma Christiana , Amupitan Emmanuel Tope , Shehu Nathan Yakubu 
Published: September 2024

Abstract

Introduction:
The COVID-19 pandemic brought about an unprecedented number of people to be isolated and this negatively impacted on manifestations of various anxiety and depressive symptoms. Our study determined the prevalence of anxiety and depressive symptoms and the associated sociodemographic and clinical factors among discharged COVID-19 patients in North-Central, Nigeria.

Methods:
One hundred and sixteen discharged COVID-19 patients were assessed in a cross-sectional study during the early phase of the COVID-19 outbreak in Jos, North-Central, Nigeria. The age, gender, educational level, length of stay in isolation, and presence of symptoms of COVID-19 were assessed with a semi-structured questionnaire designed by the authors. The Hopkins Symptom Checklist-25 was used to assess for the symptoms of anxiety and depression among participants.

Results:
The mean age was 38.7 ± 14.6 years. More men (59%) were assessed with 67.2% of the participants “ever married,” and 43% had tertiary education. Voluntary admission was 62% and about 14% had symptoms of COVID-19. Forty-three percent had stayed for more than 10 days. The prevalence of symptoms of anxiety and depression was 17.2% and 9.5%, respectively, with 10.3% having combined symptoms. No significant association between the various sociodemographic and clinical factors, with symptoms of anxiety, except for the female gender which was significantly associated with depressive symptoms (P = 0.026).

Conclusion:
Isolation and COVID-19 impact on the manifestation of anxiety and depressive symptoms. Screening for anxiety and depressive symptoms should be integrated into the comprehensive psychological management of patients, especially for epidemic-prone diseases like COVID-19 that are associated with stigma.
Pattern and Outcome of Pediatric Cardiac Surgery in University of Nigeria Teaching Hospital, Enugu: A Setting of West African Sub-region
Authors: Amah Christopher C. , Adiele Daberechi Kenneth , Chigbo Nnenna N. , Nwankwo Elochukwu , Obianyo Ijeoma , Anekwu Emelie M. , Lasebikan Nwamaka N. , Obianyo Nene 
Published: September 2024

Abstract

Background:
Paediatric cardiac surgery is highly challenging, especially in resource-limited economy like ours. The burden of heart diseases in children is huge and increasing thus, the need to audit the bold step resumed by our center in the last 5 years.

Objective:
To determine the pattern and outcome of Paediatric open heart surgeries done in a tertiary hospital of West African sub-region.

Methodology:
Descriptive, cross-sectional study where medical records of all Paediatric Open Heart Surgeries done in our centre from March 2013 to July 2018 (five year period) were reviewed. We looked at pre-operative and post-operative outcome measures and compared our outcome variables with international best practices outcome.

Results:
A total of 73 children had open heart surgery within the above period. Age group Ranged from infants to adolescents with almost equal sex distribution. The mean parental age was 37 years. About 20 different procedures were done with more of ventricular septal defect closure and total correction of tetralogy of Fallot. Combined two or three procedures in a patient were done in 33 (45.21%) patients. The mean bypass time was 70.98 min, mean duration on ventilator 2.4 days, mean duration on inotropes 5.5 days, and mean duration of intensive care unit stay was 7.53 days. Blood transfusion was given in 38 (52.08%) patients. Discharge in good condition in 89.04% patients, whereas 6.9% had mortality.

Conclusion:
Despite the efforts of our foreign collaborators, there is still a yearning need for intersectoral involvement to enshrine routine open heart surgery and cardiac intervention services by training and retraining of local capacity.