bluuebunny/crossref_metadata_2025_split huggingface dataset:
Linear Scleroderma of Scalp “en coup de sabre” in a Child Presenting with Rapidly Deteriorating Acute Encephalopathy
Authors: Saleem Anzy N. , Krupanandan Ravi Kumar , Kapalavai Sudeep Kumar , Ramachandran Bala , Kathirvelu Gopinathan , Ramesh Venkateswari , Janarthanan Mahesh , Rabia Seyed , Ramamoorthy Ramkumar 
Published: August 2024

Background:
Linear scleroderma (LS) is a variant of localized scleroderma, which is termed as “en
coup
de
sabre” (ECDS) when it involves the head and/or face. Although mainly a dermatological condition, extracutaneous manifestations have been infrequently reported.

Clinical Description:
A 13-year-old boy presented with fever, altered sensorium with seizures, right hemiparesis, and right-sided upper motor neuron type of facial palsy. He was noticed to have a depression in the left frontoparietal area of the scalp with skin changes.

Management and Outcome:
The child was initially managed along the lines of acute encephalitis supported with mechanical ventilation. Brain imaging revealed tiny calcification in the left temporal and parietal lobes with altered signal intensities ipsilateral to the scalp lesion. Suspecting an association with the overlying scalp skin lesion, biopsy of the skin lesion was done which confirmed LS. The erythrocyte sedimentation rate was elevated and the antinuclear antibody was positive. The child was started on pulse methylprednisolone following which encephalopathy improved facilitating extubation. Later, he was started on subcutaneous methotrexate and he improved on follow-up.

Conclusion:
This case creates awareness regarding the association between neurological manifestations and LS EDCS, which responds favorably to immunosuppressives and methotrexate.
Quantity over quality of publications: Are we using the right metrics to judge author’s productivity and impact in biomedical research?
Authors: Verma S , Sharma H 
Published: August 2024

ABSTRACT
The “publish and flourish” culture in the biomedical field has led to an increase in the number of publications worldwide, creating pressure on researchers to publish frequently. However, this focus on quantity over quality has resulted in an inflation of the number of authors listed in articles, leading to authorship issues and the rise of fraudulent or predatory scientific and medical journals. To maintain the credibility of scientific research, it is necessary to reform the publication metrics and explore innovative ways of evaluating an author’s contributions. Traditional metrics, such as publication counts, fail to capture the research’s quality, significance, and impact. As a result, this viewpoint explores and highlights different metrics and novel methods by which an author’s productivity and impact can be assessed beyond traditional metrics, such as the H index, i10 index, FWCI, HCP, ALEF, AIF, AAS, JIF, CNA, awards/honors, citation percentile, n-index, and ACI. By using multiple metrics, one can determine the true impact and productivity of an author, and other measures such as awards and honors, research collaborations, research output diversity, and journal impact factors can further aid in serving the purpose. Accurately assessing an author’s productivity and impact has significant implications on their academic career, institution, and the broader scientific community. It can also help funding agencies make informed decisions, improve resource allocation, and enhance public trust in scientific research. Therefore, it is crucial to address these issues and continue the ongoing discussion on best method to evaluate and recognize the contributions of authors in today’s rapidly changing academic landscape.
Oral and maxillofacial surgery: Availability of specialist training and different training pathways across Africa
Authors: Oyeyemi Opeyemi Victor , Rais Mohammed Amir , Eguavoen Osamende Great , Oluwaferanmi Alufa , Abdalazez Hager , Osunronbi Temidayo 
Published: August 2024

Abstract

Background:
Oral and maxillofacial surgery (OMFS) is the surgical specialty concerned with the treatment of a broad range of conditions that affect the head, face, mouth, neck, and jaw. In Africa, there is a paucity of information about the specialist training available to aspiring African Oral and Maxillofacial Surgeons.

Objective:
This paper aimed at shedding light on the available OMFS specialist training programmes and training pathways across Africa.

Materials and Methods:
The authors searched on PubMed, AJOL, and Google Scholar using the keywords “Africa,” “Oral and Maxillofacial Surgery,” “Residency,” “Postgraduate,” and “Education” and the individual African countries in English and official languages from inception till July 11, 2022. The authors utilised a questionnaire to interview native oral and maxillofacial surgeons and dentists in African countries where there were no published data on OMFS specialist training.

Results:
A total of 21 (38.8%) African countries had OMFS specialist training programmes (n = 69). The duration of training varies between 2 and 7 years. The number of training programmes per country ranges between one and thirteen. Countries with the most training programmes for OMFS in Africa are Nigeria, Egypt, Sudan, and Algeria. Northern Africa and Central Africa had the most and least numbers of specialist training programmes in OMFS, respectively.

Conclusion:
There remains a disparity in the number of specialist training programmes available to aspiring African Oral and Maxillofacial Surgeons as compared with other parts of the world. This paper is intended to function both as a means of advocacy to increase funding and resources in support of the infrastructure and development of facilities for African OMFS specialist training programmes and also serve as a valuable reference for future research in OMFS.
Arthroscopic anterior cruciate ligament reconstruction learning curve: Analysis of operating time and clinical outcomes
Authors: Arojuraye Soliudeen Adebayo , Salihu Mohammed Nuhu , Salahudeen Abdulfatah 
Published: August 2024

Abstract

Background:
Technical proficiency for arthroscopic anterior cruciate ligament reconstruction (ACLR) is complex and requires learning and practice. Achieving an appropriate level of competency with this surgery is important for patient safety and satisfactory surgical outcomes. There is limited literature about the learning curve in ACLR in Africa.

Objectives:
This study aimed to demonstrate the learning curve associated with ACLR.

Materials and Methods:
This retrospective study on arthroscopic ACLR was conducted between January 2020 and June 2023 with a minimum of 12 months follow-up. The primary outcome measure was operation time, whereas the secondary outcome measures were functional outcome and postoperative complications.

Results:
One hundred fifty-nine ACLR met the inclusion criteria and were analysed. The mean age of the patients was 31.47 ± 9.50 years. There were 148 (93.1%) males and 11 (6.9%) females. The median operation time was 50 min (45–190 min). There was progressively decreasing operation time with increasing number of cases done until after the first 19 cases. The mean operating time for the first 19 cases was 143.89 ± 32.84 min, whereas the mean operating time for the later 140 cases was 53.81 ± 9.72 min (P = 0.000).

Conclusions:
The operation time for arthroscopic ACLR progressively decreased until after the first 19 cases. There was, however, no significant difference in the clinical outcome between the cases done during the learning curve and those done at proficiency.
Giant fibro-epithelial polyp of the vulva: A case report
Authors: Lawal Bilkisu Kankia , Yahya Anisah , Zubair Surayya Yaakub , Abubakar Murtala , Kabir Balarabe , Oguntayo Adekunle Olarenwaju , Kolawole Abimbola Omolara 
Published: August 2024

Abstract
Fibro-epithelial polyps (FEPs), also referred to as acrochordons or skin tags, are benign tumours that generally occur in women of reproductive age. They are uncommonly found in the vulva and vary in clinical appearances from small papillomatous growths to large pedunculated tumours. Typically, they are less than 5 cm. The wide range of morphological appearances of these tumours, especially when they are large, can be misinterpreted as malignant. This case involved a 30-year old multipara, 14-month post-partum who presented with a huge, irregular, firm, pedunculated mass on the right labium majus. The mass had patchy areas of skin ulceration and measured 25 cm × 15 cm × 10 cm on a 4-cm × 2-cm long stalk. It started as a 3-cm long finger-like projection with globular distal end that progressively increased in size over 7-month period. There were no swellings in other body parts. She had excisional biopsy of the mass which weighed 588 grams with histological diagnosis of inflamed FEP and had no recurrence at follow-up. This case illustrates an uncommon presentation of the second largest FEP of the vulva reported, which could be misinterpreted as malignant. Clinical, and pathological expertise with complete surgical excision are paramount for effective management to exclude atypia or malignancy and prevent recurrence.
Clinical Profile of Patients on Highly Active Antiretroviral Therapy (HAART) Seen in a Tertiary Eye Clinic
Authors: Chime Amalachukwu Amanda , Chime Michael Okwudili , Eze Ugochukwu Anthony , Eze Gloria Chizoba , Okoye Onochie Ike 
Published: August 2024

Abstract

Background:
Highly active antiretroviral therapy (HAART) is the medication regimen for the management of human immunodeficiency virus. Over time, it has been dubbed to have revolutionised the clinical course and outcomes of HIV/AIDS.

Objective:
The objective of this study is to determine the clinical factors associated with the ocular manifestation of HIV/AIDS among patients on HAART.

Materials and Methods:
This was a descriptive cross-sectional study conducted at the ophthalmology department of the University of Nigeria Teaching Hospital (UNTH) in 2017 among adult patients (≥18 years) attending the hospital’s antiretroviral therapy (ART) clinic and selected using systematic random sampling technique. Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis, with variables being summarised using frequencies and proportions. Inferential statistics (t test, Chi-square test, and Fisher’s exact test) was used to test associations between variables. A level of significance was set at a P value of less than 0.05 corresponding to a 95% confidence interval.

Results:
A majority of patients were in WHO stages 1 and 2 of HIV and the mean CD4+ cell count of the whole population was 575.0 ± 512.56 cells/µL, while that of those with ocular manifestations was 315.2 ± 290.76 and 633.7 ± 533.54 cells/µL for those who do not have ocular manifestation. There was a significant association between CD4+ cell count and ocular manifestations such as conjunctival microvasculopathy, anterior uveitis, and cytomegalovirus retinitis.

Conclusion:
Our results suggest that HAART has some positive effect on the clinical profile of people with HIV/AIDS with CD4+ count being a major determinant of ocular manifestations.
Effect of fascia closure with triclosan-coated polydioxanone suture on surgical site infection in open appendectomy wounds: A comparative study
Authors: Aderounmu Adewale A. , Olasehinde Olalekan , Wuraola Funmilola O. , Adisa Adewale O. , Lawal Oladejo O. 
Published: August 2024

Abstract

Background:
Interest in surgical site infections (SSI) has been sustained over the years because its occurrence may be ruinous to the overall success of surgical operations. The use of antimicrobial suture has been associated with a reduction in SSI, but its role in open appendectomy has not been evaluated.

Objective:
This study compared the effect of fascia closure with triclosan-coated polydioxanone (PDS) with plain PDS on SSI in appendectomy wounds.

Materials and Methods:
Ninety-three consecutive patients who had open appendectomy for uncomplicated acute appendicitis were randomised to either have fascia closure with triclosan-coated PDS (TCS) or plain PDS. Post-operative wound infection rates were compared.

Results:
SSI occurred in three of the 93 patients (3.2%), two of these occurred in the plain suture group, while one occurred in the TCS group (4.2% vs. 2.2%, P = 0.6). All three SSIs were superficial. Staphylococcus aureus was the predominant organism isolated in the infected wounds.

Conclusion:
The use of triclosan-coated polydioxanone for fascia closure in open appendectomy did not significantly affect the rate or severity of SSI. Further studies, perhaps evaluating the use of TCS in a different anatomical plane or complicated appendicitis are recommended.
Parental knowledge of HPV infection, cervical cancer and the acceptance of HPV vaccination for their children in Jos, Nigeria
Authors: Anyaka Charles U , Alero Babalola-Jacobs , Olukoya Biodun , Envuladu Esther A , Musa Jonah , Sagay Atiene S 
Published: August 2024

Abstract

Background:
Despite the high prevalence of human papillomavirus (HPV) infections and cervical cancer in Nigeria, the utilization of the HPV vaccine as a highly effective preventive measure remains low. The aim of this study was to find out if parental knowledge of HPV infection and cervical cancer influenced the acceptance of HPV vaccines for their 9–14-year-old children.

Materials and Methods:
This was a cross-sectional survey of 509 parents comprising 262 fathers and 247 mothers in 8 randomly selected communities in Jos, Plateau State Nigeria. A pretested semi-structured investigator-administered questionnaire, without identifiers, was used to collect information on parental knowledge of HPV, cervical cancer, HPV vaccine and its acceptance for their 9–14-year-old children. The data were analysed using SPSS version 23.0. Bivariate analysis was done using chi-square statistical test. Point estimates with corresponding 95% confidence interval (CI) were estimated with a value of P ≤ 0.05 was considered as statistically significant.

Results:
Five hundred and nine parents were interviewed. The mean age of the respondents was 43.7 ± 9.43 years. Most of the participants (86.1%) had formal education from primary to tertiary level. Only 1.60%, 11.60% and 1.62% of respondents had knowledge of HPV, cervical cancer and HPV vaccines respectively, whereas 67.8% of parents were willing to pay for the cancer-preventing HPV vaccines out-of-pocket. There was no statistically significant associations between parental level of education (P = 0.056), parental knowledge of cancer of cervix (P = 0.483), religion of parents (P = 0.324) and the acceptance of HPV vaccination for their children. There was a statistically significant association between parental willingness to pay for HPV vaccines if not offered free (P = 0.001) with acceptance of vaccination. Vaccine acceptability was associated with positive attitude towards the vaccine (odds ratio [OR] = 4.178; 95% CI, 1.714–10.180; P = 0.002), whereas parental knowledge of HPV, cervical cancer and HPV vaccine did not show significant association with acceptability of HPV vaccination for their children.

Conclusion:
Despite poor parental knowledge of HPV infection and cervical cancer, there was high acceptability of HPV vaccination for their children. HPV vaccination was acceptable to parents regardless of educational level or religion. Parents in Jos communities seems to have much faith in preventive vaccines as advertised by the health authorities. Accordingly, efforts should be geared towards ensuring availability, affordability and the provision of basic information regarding HPV vaccination in Northern Nigeria.
Tissue necrosis: A burden of pentazocine abuse in South East Nigeria
Authors: Cosmas Mba Uwakwe , Onyebueke Godwin , Okwesili Obinna Remigius , Enyanwuma Ifeanyi Edwin , Okorie Gabriel Maduwuike , Ohayi Samuel Robsam , Ugwu Ifeanyi Chinedu , Ezeme Mark Sunday , Okenwa Wilfred Okwudili 
Published: August 2024

Abstract

Background:
Tissue necrosis from pentazocine abuse is becoming a burden in our environment. Pentazocine is an opioid of the benzomorphan class. It is commonly used for post-traumatic and postoperative pain and vaso-occlusive pain of sickle cell disease (SCD). Its prolonged use can lead to addiction and may result in severe injection site necrosis, often worsened by infection due to a lack of aseptic principles during administration. Although pentazocine is a controlled drug in our environment, it is readily available.

Objectives:
To review patients with tissue necrosis from pentazocine injection, share the challenges in their management, and proffer solutions.

Materials and Methods:
Clinical summaries of patients with tissue necrosis and ulcers due to pentazocine addiction were reviewed.

Results:
Twenty-five patients, comprising nine females and 16 males aged 22–61 years, were recorded. Twenty had SCD, while five had other underlying conditions. The duration of abuse was 1–16 years, while the average maximum daily dose was 348.75 ± 346.04 mg. Most patients used multiple sites for injection. Lesions included abscesses, tissue necrosis with ulcers, lymphoedema, exposed necrotic bones, and osteomyelitis. Most had multidisciplinary care. The outcome of wound care was good in two. Three had major limb amputations, four died, three signed against medical advice, six were still receiving care while seven were lost to follow-up. None was completely weaned from the drug at the time of this report.

Conclusion:
Rising cases of tissue necrosis from pentazocine abuse are disturbing. Treatment is frustrating. Concerted efforts at prevention should be made to stem the tide.
Systemic risk factors for diabetic retinopathy in patients with type 2 diabetes mellitus- A cross-sectional study in a South Indian cohort
Authors: Benita Doris , Kaliaperumal Subashini , Deb Amit K. 
Published: August 2024

Purpose:
Diabetic retinopathy (DR) is a multifactorial disease. The objective of the current study was to evaluate the systemic risk factors for diabetic retinopathy in patients with type 2 DM in a South Indian Cohort.

Materials and Methods:

Design:
Cross-sectional analytical. All participants fulfilling the eligibility criteria were recruited into two groups: with DR (Group 1) and without DR (Group 2). Both groups were compared for the risk factors using univariate and logistic regression analysis and adjusted Odds ratios (OR) were calculated. Patients in Group 1 were further divided into subgroups based on severity of DR and risk factors were analysed across the subgroups.

Results:
93 patients were recruited in each group. Comparing Group 1 versus Group 2: On logistic regression analysis, factors like HbA1c >8% (adjusted OR 7.1), duration >10 years (adjusted OR 22.15), insulin treatment (adjusted OR 6.34), CKD (adjusted OR 12.18), and hypertension (adjusted OR 8.22) were associated with presence of any stage DR. Comparing risk factors across Group 1: HTN and insulin treatment were associated with severity of DR.

Conclusion:
Insulin treatment for type 2 DM was found to be an additional risk factor in our study. However, this finding needs to be further validated in future prospective cohort studies on larger sample sizes.
Incidence of adverse drug reactions among tuberculosis patients initiated on daily drug regimen in a southern district of Karnataka
Authors: Kumar R. N. Hithaish , Rao Chythra R. , Maradi Ravindra , Umakanth Shashikiran , Sanju S. V. Chidananda , Balu P. S. 
Published: August 2024

Abstract

Aim:
The study aimed to determine the incidence of adverse drug reactions (ADRs) among newly diagnosed tuberculosis (TB) patients receiving daily drug regimen with fixed-dose combination treatment under the National Tuberculosis Elimination Program.

Materials and Methods:
A community-based prospective cohort study was carried out in the Udupi district. Over 12 months, all newly diagnosed TB patients of either gender were included from 63 primary health centers and 6 community health centers, and ADRs were recorded by personal interviews.

Results:
A total of 710 patients were enrolled, among whom 453 (63.8%), were males, and 257 (36.2%) were females. Pulmonary TB was diagnosed among 510 (71.8%) and 200 (28.2%) were extrapulmonary cases. During the intensive phase (IP) of treatment, 480 (67.6%) patients reported at least one ADR and 79 (11.1%) experienced two ADRs during IP and 31 (6.5%) had ADRs during the continuation phase. Out of 480, 140 (29.2%) had gastritis, 132 (27.5%) had vomiting, 105 (21.9%) had nausea, 60 (12.5%) had skin rashes, 27 (5.6%) had drug-induced hepatitis, and 16 (3.3%) had vision problems. Among 480 patients with ADRs, 462 (96.3%) had successful treatment outcomes, the remaining 17 patients (3.5%) died, and one (0.2%) had treatment failure.

Conclusions:
Adverse events were more common in the 1st few months of treatment than in subsequent months. All mild-to-moderate ADRs were effectively managed, and most had successful treatment outcomes.
Possible Roles of Epigenetics in Stem Cell Therapy for Parkinson’s Disease
Authors: Krubaa P. 
Published: August 2024

Abstract
Parkinson’s disease (PD) is a complex neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra, leading to motor and nonmotor symptoms. While current therapies provide symptomatic relief, they do not address the underlying cause of the disease. Stem cell therapy has emerged as a promising approach to restore damaged neural circuits, and the role of epigenetics in this field has gained significant attention. DNA methylation, histone acetylation, and noncoding RNA expression are examples of epigenetic changes that influence gene expression patterns without changing the underlying DNA sequence. These changes control cell fate determination, differentiation, and maturation, making them critical to the success of stem cell-based therapies. Proper epigenetic remodeling is required during stem cell reprogramming or differentiation into dopaminergic neurons to ensure the optimal expression of genes related to neuronal identity and function. Given the potential for affecting the efficacy of stem cell therapy, increased attention needs to be given to the epigenetic processes that occur during stem cell culture and transplantation to maximize the therapeutic potential of stem cells to PD. This review article explores the intricate relationship between epigenetics and stem cell therapy for PD, providing insights into the epigenetic modifications involved in stem cell differentiation, integration, and functional recovery in preclinical and clinical settings. By examining the epigenetic factors that influence stem cell-based treatments, we aim to contribute to the development of more effective and targeted strategies for the management of PD.
Analysis of the Effectiveness of Organization-Based Learning on Nursing Performance at Regional General Hospital
Authors: Setyawan Daniel Bagus , Supratno Haris , Roesminingsih Erny 
Published: August 2024

Objective: Improving services in hospitals is related to the effectiveness of the performance of health workers, especially nurses. Nurses are also the health workers who most often and longest interact with patients. Hospitals have well received the concept of organization-based learning as a health institution. Organizational-based learning is necessary for the development of employees and the institution itself. This study analyzes the effectiveness of implementing organization-based learning on nurses' performance at Regional General Hospital Dr. WahidinSudiroHusodoMojokerto City. Method: This qualitative research uses primary and secondary data. Data collection techniques are through observation and interviews. The selection of informants in this study was carried out using the total sampling method. Results: The results showed that organization-based learning improves nurses' performance in inpatient service. Novelty: Organizational-based learning can be applied in hospitals to improve nursing performance in providing services. The head of the room must also be a good manager when implementing this program.