bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncommon and Unusual Variants of Autoimmune Bullous Diseases
Authors: Kiran  , Rao Raghavendra 
Published: August 2024

Abstract

Background:
Autoimmune blistering diseases (AIBDs) are a type of dermatosis with antibodies produced against various structural proteins of the epidermis or dermoepidermal junction. AIBDs are broadly divided into intraepidermal and subepidermal types. Apart from the common AIBDs, there is an array of uncommon AIBDs.

Objective:
To discuss uncommon variants of AIBDs so that the readers are updated about them.

Methods:
In this review, we have discussed uncommon and unusual variants like pemphigus herpetiformis, IgA pemphigus, paraneoplastic pemphigus, induced pemphigus, IgG/IgA pemphigus, oral lichenoid pigmentation in pemphigus, pemphigus acanthoma, and follicular pemphigus. Rarer variants of the pemphigoid group of disorders include anti-laminin 332 pemphigoid, mixed linear IgA/IgG pemphigoid, anti-p200 pemphigoid, Brunsting-Perry pemphigoid, IgM pemphigoid, granular C3 pemphigoid, anti-p105 pemphigoid, ORF-induced anti-laminin 332 pemphigoid, and acral purpura in dermatitis herpetiformis.

Conclusion:
This review will help in early diagnosis and treatment of uncommon and unusual variants of AIBDs.
Pediatric Basidiobolomycosis: An Uncommon and Misdiagnosed Entity
Authors: Choudhary Ritul , Tiwari Charu , Borkar Nitinkumar , Ganguly Satyaki , Keche Archana 
Published: August 2024

Abstract
Basidiobolomycosis is an unusual chronic subcutaneous zygomycosis reported from tropical regions which is usually misdiagnosed because of its rarity. In this retrospective review, we describe 6 children with basidiobolomycosis who were managed in the Department of Paediatric Surgery at a tertiary institute in central India over a period of four and half years (January 2018 to June 2022). All patients were less than 5 years of age and had no co-morbidities (immune-competent). All were males. All were misdiagnosed at outside hospital. All responded well to anti-fungal therapy. High index of suspicion and biopsy of the lesions lead to appropriate diagnosis and management. Management appears good with triazole antifungals with fewer side effects and safety in children.
Resuscitation Endpoints in Polytrauma Patients: Fixed or Dynamic
Authors: Ali Sarah M. , Faqiri Shahad A. , Osman Adel G. E. , Othman Arwa A. , Almarri Ahmed K. 
Published: August 2024

Abstract
Shock results from insufficient oxygen delivery, leading to metabolic acidosis, inflammation, and coagulopathy. Resuscitation aims to restore normal physiology by addressing various haemodynamic, metabolic, and regional endpoints that gauge the severity of shock. While numerous endpoints exist, no universal standard applies. This review critically examines the importance of endpoints in resuscitation in the management of shock and the improvement of trauma patients’ outcomes. A thorough literature search and analysis highlighting effective endpoints in clinical practice and areas necessitating further investigation was carried out. Established markers such as serum lactate, base deficit, and pH offer valuable insights over time, although a single value may not suffice. Early controlled resuscitation in haemorrhagic shock and tailored haemostatic approaches enhance survival rates. Damage control resuscitation strategies have been proven to improve outcomes by prioritizing haemorrhage management as an additional endpoint. As trauma is a dynamic condition that changes from minute to minute based on the patient’s condition during the acute phase, it is imperative that resuscitation strategies and endpoints remain dynamic during this phase to effectively accommodate changes in the patient’s condition. This belief is supported by the wide variation in endpoints without a consensus on a single endpoint or value.
Resuscitative Thoracotomy for Penetrating Trauma, a Valid Option in the Right Circumstances
Authors: Alhussain Youssef F. , Almuhanna Mustafa T. , Bawab Hatem Y. , Osman Adel G. E. , Nabri Mamoun A. , Nasr Ayman O. 
Published: August 2024

Abstract
The need to perform a clamshell thoracotomy in the emergency department for thoracic injuries is infrequent. The rates of survival after emergency thoracotomy are considerably low, with penetrating trauma cases exhibiting survival rates of 9% to 12%, and blunt trauma cases observing survival rates of 1% to 2%. We present an atypical instance of survival following resuscitative thoracotomy performed in the emergency department. The procedure was undertaken on a 30-year-old male victim of gunshot wounds to the chest and abdomen. On arrival to emergency department, the patient had a traumatic cardiac arrest. A resuscitative thoracotomy was carried out, restoring a spontaneous heart rhythm before transferring the patient to the operating room. A midline exploratory laparotomy was performed for abdominal injuries. Remarkably, the patient survived the procedure and fully recovered. This case serves as an illustration of how clamshell thoracotomy can be an effective resuscitative lifesaving intervention for penetrating thoracic trauma when accompanied by the appropriate setup.
Comparison of Two Educational Methods for Teaching European Paediatric Advanced Life Support to Adults: Formative Versus Summative Evaluation—A Pilot Investigation
Authors: Alouini Amenne , Biarent Dominique , Mbarek Rabeb , Tilouche Samia , Alouini Souhail , Haggenmacher Caroline 
Published: August 2024

Abstract

Background:
This study compared formative assessment with traditional summative assessment during European Paediatric Advanced Life Support (EPALS) courses. With increasing emphasis on the effectiveness of medical teaching methods, this study aimed to evaluate the impact of these assessment approaches on perceived stress levels and overall satisfaction of healthcare professionals participating in the EPALS course.

Materials and Methods:
A pilot investigation study was carried out to compare two EPALS courses run simultaneously. The courses used two different assessment methods: one used a summative evaluation at the end of the course, while the other implemented summative assessment throughout. The study examined the stress levels perceived by participants during the different phases of training when using subjective measures. In addition, participants’ satisfaction with the course, assessment methods, and overall experience was assessed using Likert scale responses.

Results:
Participants undergoing formative assessment reported significantly lower stress levels during assessment periods than those in the summative evaluation group. Both groups of participants were satisfied with the course. However, the formative group preferred formative assessment, while the summative group was more neutral. The formative group strongly believed that formative assessment was more objective than a summative test (P = 0.011) and that certification held the same value as after a summative test (P = 0.046), whereas the summative group believed that a formative assessment was neither more nor less objective.

Conclusion:
This study sheds light on the potential benefits of formative assessment in reducing perceived stress during training and increasing the satisfaction of participants of EPALS courses.
Determining the effects of botulinum toxin A treatment on pain, resting vaginal pressure, and female sexual distress scale among vulvodynia patients
Authors: Rajar Uzma D.M. , Ayub Uzma T. , Qazi Sumayya 
Published: August 2024

Introduction
Vulvodynia is a painful and constant vulvar discomfort. This condition is often described as a searing or stinging sensation, with an increased awareness of pain (hyperalgesia) and pain sensitivity (allodynia).

Objective
To determine the effects of botulinum toxin A treatment on pain, resting vaginal pressure, and female sexual distress scale among vulvodynia patients.

Patients and methods
A quasi-experimental study was performed on 40 patients with vulvodynia. The assessment was done 3 months after botulinum toxin injection by visual analog scale, vaginal pressure at rest, and female sexual distress scale.

Results
The findings revealed that the effect of treatment was turned out to be significantly effective (P<0.05) in reducing pain and measured using visual analog scale where the values at baseline were 8.25±3.41, which reduced to 4.37±2.12 after 3 months of intervention. In addition to that female sexual distress scale also shown a significant reduction after 3 months of treatment. The improvement was noticed with a mean difference of mean differnce=8.21±3.58 (P<0.05, 95% confidence interval). Furthermore, it was shown that botulinum toxin A therapy significantly decreased resting vaginal pressure.

Conclusion
Botulinum toxin type A therapy is a potential alternative for treating female vulvodynia.
Effect of Photobiomodulation Therapy in Type 2 Diabetic Patients on Peri-implant Osteoblastic Activity, Soft-tissue Healing, and Postoperative Pain Discomfort: A Pilot Study
Authors: Selvam Divyabharathi , Natrajan Shanmuganathan , Seenivasan Madhan Kumar , Lavu Vamsi 
Published: August 2024

Background:
Surgical and postoperative challenges impose the need for noninvasive techniques to enhance bone healing process and reduce complications during implant therapy in diabetic patients. Photobiomodulation therapy (PBMT) has shown a substantial effect in the management of postoperative pain, neurosensory recovery, and healing at surgical sites.

Objectives:
The present study aimed to assess the effect of PBMT on peri-implant osteoblastic activity, soft-tissue wound healing, and Post operative pain discmofort among type 2 diabetic patients.

Material and Methods:
Five type 2 diabetic patients with bilaterally edentulous mandibular posterior teeth necessitating 10 implants with two-segment variant type were included in the study. The study site (SS) with implants was treated with PBMT (gallium–aluminum–arsenide diode laser 810 nm), and the control site (CS) with implant (opposite side) was left untreated. The Wound Healing Index (WHI), Visual Analog Scale, and bone scintigraphy were used to assess postoperative discomfort and peri-implant osteoblastic activity, respectively.

Results:
The average WHI scores and Visual Analog Scale at the SS were not significantly higher than the CS score. Although lack of significant increase in osteoblastic activity was observed under bone scan, the difference in experimental values highlights a possible association of PBMT and osseointegration potential among the study group.

Clinical Implications:
The application of Photobiomodulation Therapy (PBMT) as an adjunct around dental implants will improve osteoblastic activity and bone healing to reduce the probability of early-onset failures in patients diagnosed with type 2 diabetes mellitus. However, to assess the impact of the PBMT on peri-implant bone with different bone densities, further well-controlled long-term trials on larger study groups are needed.

Conclusion:
Within the limitations of the study, irradiation using PBMT at the peri-implant tissue site has shown favorable osteoblastic activity, WHI score, and Visual Analog Score postoperatively, but the results were statistically not significant. However, further long-term trials on diabetic individuals on a larger scale are needed for validating these study results.
Prevalence of Inborn Errors of Immunity in Children with Recurrent Multilobar Pneumonia in a Tertiary Care Center in Tamil Nadu
Authors: Balaji B. Sarath , Arunagirinathan V. , Karthikeyan S. 
Published: August 2024

Background and Objective:
Underlying immunodeficiency is a risk factor for recurrent pneumonia. We tried to estimate the prevalence of inborn errors of immunity (IEI) in children with recurrent multilobular pneumonia and analyzed the history, examination findings, and basic investigations to derive clues for early diagnosis in a resource-poor hospital setting.

Materials and Methods:
This prospective observational study was conducted in a tertiary care pediatric teaching hospital in South India over 2 years. Details about each patient including demographics, clinical profile, treatment history, and outcomes were obtained.

Results:
Among 76 children with recurrent multilobar pneumonia, 30 children (39.47%) were proved to have IEI. The significant pointers to the diagnosis of IEI in history were chronic recurrent rhinosinusitis (P < 0.001), otitis media (P = 0.033), tonsillar atrophy (P = 0.022), widespread skin and soft-tissue infections and abscesses (P < 0.001), mucosal candidiasis (P = 0.008), recurrent diarrhea (P = 0.016), lymphopenia for age (P < 0.001), thrombocytopenia (P = 0.005), and abnormal peripheral smear other than hypochoromic microcytic anemia (P < 0.001).

Conclusions:
IEI prevalence is higher than expected with some easily appreciable clues in basic examination and laboratory findings. Clinicians should keep these pointers in mind while dealing with any child with recurrent pneumonia.
Unveiling the mystique of Kulisam (Amulet) with scientific insight
Authors: Ramasamy Kayathri , Ulaganathan Sarojini , Sengottaiyan Geetha Devi 
Published: August 2024

Abstract

Background:

Kulisam is an unexplored therapy of Siddha paediatrics. In which an amulet is prepared with medicinal herbs, metals and some animal product. Most of the herbal ingredients of Kulisam contain essential oils. It enters the body through the skin inhalation and ingestion routes, it gets mixed with the circulation and cures the specified diseases thus acting as a therapeutic agent.

Materials and Methods:
The data were obtained from Siddha classics such as, TV Sambasivam Pillai dictionary, Kuzhandhai maruthuvam, Vaazhai vagadam and various research articles searched in Pubmed, Google Scholar and Science Direct through specific keywords.

Result and Discussion:
The herbal and metal amulets used in Siddha pediatrics have been explored with the help of science. Therefore, Kulisam can act as a potent therapeutic, pharmaceutical and, nutraceutical tool for Siddha paediatrics. For a long period of time the unique therapy of Siddha system of medicine – Kulisamaadal has been alienated due to the unexplored science base behind it and a lack of research in this aspect, it's left as an unexplored treasure. Having a significant scientific base behind further research on this aspect will take Siddha pediatrics to the next level.

Conclusion:

Kulisam is a therapeutic tool of Siddha paediatrics. Being an unexplored therapy of the Siddha system, it is essential to conduct further studies and research on this aspect.
Clinical management of Kandamaalai (Cervical Lymphadenopathy) through higher-order Siddha medicines: A case report
Authors: Thangapandi Swathi , Shanthirappa Udayar Sivakkumar 
Published: August 2024

Abstract
Cervical lymphadenopathy, characterized by the swelling of lymph nodes in the neck region, presents a complex clinical scenario with varied aetiologies. The integration of traditional medicinal systems, like Siddha, offers potential alternative therapeutic approaches. This case study deals with the management of bilateral cervical lymphadenopathy using Siddha remedies tailored for Kandamaalai. A 47-year-old female patient presented with a two-month history of cervical swelling, throat discomfort, otalgia, rhinitis, and anorexia. Diagnosis revealed bilateral cervical lymphadenopathy, akin to the Siddha concept of Kandamaalai. Treatment involved Siddha medications targeting Kandamaalai, administered without adverse effects. Subsequent improvement was clinically observed, with the resolution of symptoms and reduction in lymph node size corroborated by ultrasound (USG) findings. This case underscores the potential efficacy of Siddha therapy in treating cervical lymphadenopathy, particularly Kandamaalai. Further research, including robust clinical trials, is essential to validate these outcomes and elucidate the role of Siddha medicine in contemporary healthcare settings.
Visual Impairment Among Adult Diabetic Patients and Associated Factors at Debre Brihan Referral Hospital, Central Ethiopia, 2017
Authors: Demilew Ketemaw Z. , Adimassu Nebiyat F. , Alemu Destaye S. 
Published: August 2024

PURPOSE:
The study aimed to assess the proportion of visual impairment and associated factors among diabetic patients at Debre Berhan Referral Hospital (DBRH).

METHODS:
A hospital-based cross-sectional study was carried out from April 27 to May 19, 2017. All adult diabetic patients attending DBRH during the study period were included in the study. A pretested, structured questionnaire and clinical examinations were used for data collection. The collected data were entered into Epi Info 7 and exported to the Statistical Package for Social Sciences version 20 for analysis. The descriptive analysis was summarized by frequency, percent, and summary statistics. Association between visual impairment and independent variables was determined via bivariable and multivariable binary logistic regressions. P < 0.05 was considered statistically significant. Adjusted odds ratio (AOR) and 95% confidence interval (CI) were used to determine the strength of association. Hosmer and Lemeshow goodness of fit was used to check for model fitness.

RESULTS:
A total of 388 study subjects with a 92% response rate took part in the study. The prevalence of visual impairment was 29.38% (95% CI: 24.83%–33.93%). Age >56 years (AOR = 5.24, 95% CI: 1.37–20.04), physical inactivity (AOR = 2.34, 95% CI: 1.33–4.14), presence of visual symptoms (AOR = 4.48, 95% CI: 2.35–8.57), lower body mass index (AOR = 6.23, 95% CI: 1.87–20.68), and diabetic retinopathy (AOR = 5.12, 95% CI: 1.91–13.70) had a statistically significant association with visual impairment.

CONCLUSION:
A high proportion of diabetic patients had visual impairment. Independent variables older age, physical inactivity, presence of visual symptoms, lower body mass index, and diabetic retinopathy had a positive statistically significant association with visual impairment.
Standardization of Quantitative Dengue Virus Nonstructural-1 ELISA for Quantitation of Dengue Virus Nonstructural-1 Levels in Human Serum
Authors: Bhatt Puneet , Devadiga Santhosha , Varma Muralidhar , Mukhopadhyay Chiranjay 
Published: August 2024

ABSTRACT

Introduction:
Dengue virus (DENV) infection is a significant global public health problem, caused by four antigenically distinct serotypes of DENV, namely, DENV-1, DENV-2, DENV-3, and DENV-4. The disease manifestations range from asymptomatic or mild undifferentiated fever to severe diseases such as dengue hemorrhagic fever and dengue shock syndrome. Extensive research has been done on pathogenesis of DENV infection and the factors responsible for its severe manifestations. However, there is no ideal prognostic biomarker available yet. In various studies, it has been observed that DENV nonstructural-1 (NS1) protein plays a crucial role in pathogenesis. DENV NS1 protein acts by various mechanisms such as direct effect on vascular endothelium and activation of alternate complement pathway, which causes the release of inflammatory cytokines, leading to plasma leakage. It has also been observed that DENV NS1 levels correlate with disease severity. Until the present date, no commercial quantitative DENV NS1 ELISA is available for quantifying DENV NS1 levels in patients of DENV infection.

Aim:
Standardization of quantitative DENV NS1 ELISA.

Methods:
This study utilizes an already available NS1 ELISA kit and known concentrations of recombinant DENV NS1 protein to standardize quantitative DENV NS1 ELISA to estimate the NS1 concentration in human sera.

Conclusion:
Commercially available DENV NS1 detection kits can be standardized for quantification of DENV NS1 in human sera and use this data to find the association between NS1 concentration and disease severity.
A Study on the Clinical Profile and Complications of Snake Bite among Patients at a Tertiary Care Centre in Western Odisha
Authors: Pradhan Jagannath , Majhi Chakradhar , Pradhan Sasmita 
Published: August 2024

ABSTRACT

Background:
India is a country known to the West as a country of snake charmers and snakes. Generation after generation, some families in our country continue to play and live with snakes (snake charmers), but we fail to protect the community from snake bites. Protection from this environmental and occupational hazard requires at least some education of the public with regard to how to protect them from snake bites, as well as what to do after the bite has occurred.

Methods:
The clinical profile of 88 patients who were admitted to the hospital with snake bites and gave informed consent were studied. Patients were treated with anti-snake venom (ASV) whenever required, the initial dose and total dose of ASV administered were also calculated.

Results:
Most patients were male (54.5%). The majority of the cases (39.8%) were farmers, followed by housewives (15.9%), daily-wage laborers (13.6%), students (11.4%), and shopkeepers (4.5%). The most common clinical manifestation was an extension of edema beyond the site of bite (29.5%) followed by neurological features (26.1%), pain abdomen (20.5%), vomiting (14.8%), and regional lymphadenitis (12.5%). Out of the 88 cases, 11 cases died and the remaining 77 cases recovered. Mortality was significantly higher among patients with complications such as wound infection (P < 0.0010.000), sepsis (P = 0.000), compartment syndrome (P = 0.028), and haematuria (P = 0.004).

Conclusion:
Snakebite is an occupational hazard, as more than half of the patients were farmers and labourers. The risk factors such as the time between bite and treatment, snake bite -related complications, and adequate doses of ASV determine the treatment outcome.
Usefulness of CRP as a Prognostic Marker in the Clinical Course of Covid-19 Infection during the Three Waves
Authors: Alapaty Shailaja , Dhulipala Suhas , Natikar Jyothi A , Ajit H , Sirsikar Mangala , Annavarapu Umalakshmi , Mahendrakar Deepthi 
Published: August 2024

Introduction:
COVID-19 is an emerging public health problem. It comprises of a large virus family causing varying infection ranging from common cold to more severe infection. Classification of cases into mid, moderate, severe helps for effective management and treatment. CRP is a highly sensitive biomarker for inflammation, tissue damage.

Materials and Methods:
A retrospective cohort study was done during March 2020 to Feb 2021. Total 2,239 patients were included in the study. CRP levels were measured in hospitalized patients on the day of admission.

Statistical Analysis:
Continuous variables are presented as Mean ± standard deviation and Median (Q1, Q3). Qualitative variables are presented as frequency and percentage. The continuous variables were compared using independent t test, one-way analysis of variance or Kruskal–Wallis test. Receiver operating characteristic curves (ROC) were constructed to identify the predictability and best cut-offs of variables to differentiate moderate illness from severe–critical illness, severe illness from critical illness, and survivors from non-survivors. A two-tailed P value <0.05 was considered statistically significant.

Results:
We found a significant increase in CRP values in patients with critical illness in wave-1 and wave-2. The levels of CRP increased as the severity of disease progressed. The CRP had a sensitivity of 71.3% and specificity of 59.8% in critically ill patients in wave-1. In wave-2, the sensitivity of 70.10% and specificity of 56% in critically ill patients. In wave-3, the sensitivity of 75% and specificity of 20.3% in severely ill patients. This indicates that CRP can be used as a marker for disease progression. The Youden index J is 0.3978 and the association criterion is >1.85.

Conclusion:
CRP is a simple test that helps in initiating primary care. It indicates the severity of disease in COVID-19 infection. CRP can be used as a marker for disease progression and also indicates the severity of lung involvement.