bluuebunny/crossref_metadata_2025_split huggingface dataset:
Symptomatic orbital metastasis as an initial presentation of adenocarcinoma lung: A case report and review of literature
Authors: Patidar Yaman , Saldhana Smitha C. , Babu M. C. Suresh , Jacob Linu Abraham , Rudresh A. H. , Lokesh K. N. , Rajeev L. K. 
Published: August 2024

ABSTRACT
Orbital metastasis is a rare entity in oncology. With increasing awareness and advancement, patients with initial ocular presentation can be diagnosed and treated. Ocular metastasis is more common in breast cancer followed by lung cancer. Lung cancer with ocular presentation generally have poor prognosis because of difficult diagnosis, Vision impairment and delayed management. Here, we report one such case of 59 year old female presented with painful periorbital swelling in left eye for 3 months with no pulmonary symptoms. On evaluation, she was diagnosed as ocular metastasis with primary being lung adenocarcinoma. Through this case, we enlighten the epidemiology, presentation, clinical features and evaluation of such patients which might help clinicians in further management.
Comparative Effectiveness of Therapies in 2665 Elderly Patients with Ruptured Intracranial Aneurysms
Authors: Ding Yasuo , Hu Jia , Zhou Bin , Sun Xiaochuan , Song Yanbing , Leng Bing , Zheng Yongtao 
Published: August 2024

Background:
The optimal treatment strategy for elderly patients with ruptured intracranial aneurysms (IAs) remains controversial. We evaluated a national, multihospital database to compare the outcomes of aggressive treatment and medical management for those patients.

Methods:
We performed a retrospective analysis of 2665 elderly patients with ruptured IAs admitted to 11 hospitals in China. Patients were divided into three age groups (60–69, 70–79, and 80 years or older). Multiple logistic regression was used to estimate the odds ratio for favorable and unfavorable outcomes.

Results:
Patients between 60 and 69 years old undergoing endovascular treatment (EVT) had significantly decreased morbidity (13.7% versus 19.7% and 29.9%), compared to those who underwent clipping and medical management, similar mortality to patients who underwent clipping (3.6% versus 2.6%), and decreased mortality (3.6% versus 8.7%) to patients who underwent medical management. Coiled patients 70 to 79 years old had lower morbidity (21.3% versus 33.8%) and mortality (2.8% versus 11.3%) compared to patients who underwent medical management and similar mortality (21.3% versus 27.2%) and mortality (2.8% versus 4.8%) to patients who underwent clipping. Multivariate logistic regression analysis demonstrated that factors associated with discharge status were age, poor mFisher grade, poor WFNS grade, hypertension, diabetes, smoking, aneurysms 4 mm or larger, and middle cerebral artery aneurysms.

Conclusions:
Elderly patients treated with EVT had significantly less morbidity and mortality than those treated with clipping and medical management. A comprehensive assessment of the general state of elderly patients and IAs characteristic may help us to predict patients’ prognosis.
Alternative Splicing in Glioblastoma and its Clinical Implication in Outcome Prediction
Authors: Zheng Ping , Zhang Xiaoxue , Ren Dabin , Bai Qingke 
Published: August 2024

Background and Objective:
Alternative splicing (AS) offers an important mechanism to form protein polymorphism. A growing body of evidence indicates the correlation between splicing abnormality and carcinoma. Nevertheless, an overall analysis of AS signatures in glioblastoma (GBM) is absent and urgently needed.

Methods:
TCGA SpliceSea data was used to evaluate the AS profiles and further classified into different AS events. The survival analysis was based on these AS events, and AS-related genes were identified and performed with enrichment analysis. At last, the splicing factor–AS regulatory network was established in Cytoscape.

Results:
Eight hundred forty-two splicing events were confirmed as prognostic molecular events in GBM. Furthermore, the final prognostic signature constructed by seven AS events gave good result with an area under the curve (AUC) of receiver operating characteristic (ROC) curve up to 0.935 for five years, showing high potency in predicting patients’ outcome. We built the splicing regulatory network to show the internal relationship of splicing events in GBM. PC4 and SFRS1 interacting protein 1 (PSIP1) and histone H4 acetylation may play a significant part in the prognosis induced by splicing events.

Conclusion:
In our study, a high-efficiency prognostic prediction model was built for GBM patients based on AS events, which could become potential prognostic biomarkers for GBM. Meanwhile, PSIP1 may be a critical target for pharmaceutical treatment.
Montreal Cognitive Assessment (MoCA): Normative Data for the State of Kerala, South India
Authors: Iype Thomas , Raghunath Sreelakshmi P. , Paddick Stella M. , Sudha Lijimol A , Krishnapilla Vijayakumar , Nair Sanjeev , Robinson Louise 
Published: August 2024

Background:Montreal cognitive assessment (MoCA) is a tool that is widely accepted across the world to measure mild cognitive impairment (MCI). The original cut-off score of MoCA falsely screens a large population of Indians as having MCI.Objective:The aim of this study was to develop the normative data for MoCA for the older population of Kerala, South India.Material and Methods:We conducted the study among 959 cognitively normal older individuals of Kalliyoor village of Thiruvananthapuram district, Kerala. The validated Malayalam version of MoCA [MoCA-M] was administered by trained volunteers. The mean, median, and 10thpercentile of the scores [domain-specific and total] were calculated in various age and educational groups.Results:The mean (SD) MoCA score was 19.4 (7.3). The 10thpercentile for the total MoCA score was 9. The 10thpercentile for all domains was zero, except for orientation. As age advanced, MoCA scores significantly reduced. The mean total MoCA scores dropped from 20.1 (7) [for ages between 65 and 75 years] to 7.4 (1.6) [for ages above 85 years]. We also obtained a significant improvement in scores among subjects with higher educational standards.Conclusion:The study throws light into the performance of MoCA among the Indian population. This study defines the norms for the Indian population and suggests redefining the threshold for positively screening for MCI using MoCA-M.
Restless Legs Syndrome Affects Sleep in de novo Parkinson’s Disease Patients
Authors: Choi Seong-Min , Cho Bang-Hoon , Cho Soo H , Kim Byeong C 
Published: August 2024

Background:
Restless legs syndrome (RLS) is common in Parkinson’s disease (PD) patients and can affect the motor symptoms and non-motor symptoms (NMSs) of PD patients.

Objective:
This study aimed to identify the clinical factors affected by RLS in patients with PD.

Methods:
We included 369 de novo PD patients. RLS was assessed by face-to-face interviews and the motor symptoms and NMSs of the patients were assessed using relevant scales.

Results:
RLS frequency in the patients was 12.2% (45/369). PD patients with RLS (PD-RLS) exhibited a greater global Pittsburgh Sleep Quality Index (PSQI) score than those without RLS (PD-No RLS). PD-RLS exhibited significantly greater scores in the daytime dysfunction and sleep disturbances components of the PSQI than PD-No RLS. PD-RLS exhibited a significantly greater score in the sleep/fatigue domain of the Non-Motor Symptoms Scale than PD-No RLS. The International RLS Study Group rating scale score was significantly related to PSQI components scores in the sleep disturbances, sleep latency, habitual sleep efficiency, and subjective sleep quality.

Conclusions:
RLS frequency in de novo PD patients is higher than that in the general population, and the main NMS affected by RLS in these patients is sleep disturbances. Therefore, it is necessary to manage RLS in PD patients with sleep disturbances.
Sleep in Myasthenia Gravis: A Questionnaire-Based Study
Authors: Kumar Rakesh , Nayak Chetan , Nagappa Madhu , Rao Shivaji , Sinha Sanjib , Taly Arun B 
Published: August 2024

Background:
Disturbed sleep and its impact on quality of life (QoL) are underrecognized in myasthenia gravis (MG).

Aims:
To evaluate the quality of sleep in MG using standard sleep questionnaires and assess factors that determine sleep.

Settings and Design:
Prospective, cross-sectional, hospital-based study.

Patients and Methods:
Fifty patients on stable drug therapy for at least 1 month and age- and gender-matched controls were assessed using standard sleep questionnaires [Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and NIMHANS Comprehensive Sleep Disorders Questionnaire (NCSDQ)].

Results:
Myasthenia Gravis Foundation of America (MGFA) grade was I, IIA, IIB, IIIA, IIIB, and IVA in 11, 19, 3, 10, 6, and 1 respectively. The mean PSQI and ESS scores were similar in patients and controls. Patients with abnormal ESS (>10) were older and had greater neck circumference (P = 0.018 and <0.001). Body mass index was greater in patients with PSQI > 5 (P < 0.05). Age, gender, and clinical severity did not affect PSQI. Compared with ESS and PSQI, NCSDQ showed higher frequency of disturbed sleep, snoring, early morning headache, difficulty in initiation, and maintenance of sleep in MG, although the differences between patients and controls were not significant. No correlation was found between QoL and ESS or PSQI.

Conclusion:
Patients of MG with stable clinical course with adequate treatment have sleep quality comparable with healthy controls. Longitudinal assessment of sleep quality at multiple time points throughout the disease course and correlating with cross-sectional disease severity may further delineate the impact of disease on sleep and QoL.
Neutrophil-to-Lymphocyte Ratio, ESR, and CRP Have No Roles as Markers for Disease Severity and Prognosis in Patients with RRMS
Authors: Nikseresht Alireza , Bahrami Zahra 
Published: August 2024

Background:
Up to now, there is no definitive prognostic factor for patients with multiple sclerosis.

Objective:
This study aimed to evaluate the neutrophil-to-lymphocyte ratio (N/L ratio) as a cheap, available, and noninvasive marker for disease activity and prognosis.

Material and Methods:
A total of 112 patients, who were diagnosed with relapsing-remitting multiple sclerosis (RRMS), and 61 healthy controls were considered. We evaluated N/L ratio, ESR, CRP in the control, and patients in the first attack of the onset of the disease, 1 month and 6 months later during remission. All patients received interferon or Glatiramer acetate as disease-modifying therapies. The correlation of parameters with Expanded Disability Scale Score (EDSS) and Functional System (FS) involvement was evaluated.

Results:
The N/L ratio was increased significantly in patients with MS in the relapse phase (mean: 2.44 ± 0.68) compared to the healthy controls (mean: 1.84 ± 0.67) (P = 0.04). Also, we found a significant increase in CRP among the aforementioned groups (P = 0.028). A significant correlation was not found between NLR, ESR, or CRP and patient’s EDSS during 6 months of follow-up. For ESR and the type of functional system, a significant difference was found between favorable and unfavorable categories, while the median (IQR) of ESR in the favorable group was 7.7 (4–12) and among unfavorable ones was 13.8 (6–17.75) (P = 0.008).

Conclusions:
The results showed the effect of the innate immune system and inflammation during MS attacks. We considered that neutrophils, ESR, and CRP cannot predict disease severity or prognosis at least without a combination of other biomarkers.
Evaluation of Excess Deaths in a Tertiary Hospital in Urban Northern Nigeria during the COVID-19 Pandemic (EDiK-2020 Study)
Authors: Galadanci Hadiza S. , Abubakar Isa S. , Musa Baba M. , Adamu Aishatu , Gadanya Muktar A. , Tsiga-Ahmed Fatimah , Kwaku Aminatu A. , Jalo Rabiu I. , Bashir Usman , Abdullahi Hadiza M. , Farouk Zubaida , Dankishiya Faisal S. , Amole Taiwo G. , Aliyu Muktar H. 
Published: August 2024

Context:
The morbidity and mortality arising from the COVID-19 pandemic in low- and middle-income countries were further worsened by the disruption in health systems and diversion of strained health resources for emergency response.

Aim:
This study ascertained whether there was an increase in the number of deaths recorded in Kano, Nigeria, during the pandemic, compared to the preceding 3 years and identified the potential causes of these deaths.

Materials and Methods:
Using a retrospective design, data were collected from a tertiary hospital in Kano from January to June 2020. Data on number and date of deaths, as well as clinical information of the deceased, were retrieved from hospital records. Comparison data were collected on all deaths and admissions in the hospital within a similar period (January–June) of 2017–2019.

Results:
The age of the deceased ranged from one day to 115 years, with the majority being males (n = 414; 63.2%) and adults (n = 491; 75.0%). The majority did not have history of recent travel (n = 570; 87.0%), contact with COVID-19 suspected cases (n = 622; 95.0%), or confirmed COVID-19 (n = 625; 95.4%). Slightly less than half (n = 262; 46.2%) died within 24h of admission. The majority (n = 452; 79.7%) died within 7 days of admission. The most common cause of death recorded on admission was sepsis (n = 66; 10.1%), while 53 (8.1%) were brought in dead. SARS-CoV-2 infection was the documented cause of death in twelve patients (1.8%). More than half (n = 378; 57.7%) had underlying medical conditions, of which hypertension (n = 172; 45.5%) was the most common. The highest annual average deaths (178) and admissions (2179) were recorded in 2019, while 135 deaths and 1532 admissions were recorded in 2020. Most deaths occurred in April 2020 (208), while the highest number of admissions was recorded in March 2020. Mortality was higher in April of 2020 (14.1%, 95% CI: 12.4%–16.0%) compared to the same month in 2017 (7.6%, 95% CI: 5.9%–9.7%), 2018 (8.4%, 95% CI 7.0%–10.2%), and 2019 (8.5%, 95% CI 7.3–9.8%).

Conclusion:
In summary, we found excess mortality rates during the COVID-19 pandemic in Kano, Nigeria, consistent with prior studies.
A Multicenter Retrospective Study on Magnitude, Distribution, Socio-Demographic, and other Risk Factors Associated with Hemodialysis in Jigawa State, Northwest Nigeria
Authors: Ibrahim Usman Muhammad , Jibo Abubakar Mohammed , Bashir Usman , Aliyu Muhammad Sabiu , Jalo Rabiu Ibrahim , Zubairu Zahrau , Muazu Salisu , Buba Luka Fitto , Lawrence Ademola Babatunde , Sidi Kamalu Shehu , Abdulsalam Kabiru , Karkarna Mustapha Zakariyya 
Published: August 2024

Context:There is a growing concern regarding increasing cases of kidney diseases in Jigawa state, with most conditions requiring hemodialysis or other forms of renal replacement therapy.Aim:This study aimed to find the magnitude, distribution, socio-demographic, and other factors associated with hemodialysis in Jigawa state, Northwest Nigeria.Materials and Methods:It was a retrospective multicenter analysis of secondary data from hemodialysis centers of the randomly selected public hospitals in northwest Nigeria.Statistical Analysis:Data were analyzed using IBM SPSS Statistics for Windows, version 22.0, with statistical significance set atP≤ 0.05.Results:A total of 1,329 patients were enrolled for dialysis in Kano and Jigawa states, between 2019 and 2022, out of which more than one-third (509, 38.3%) were from Jigawa state. Dutse, Jahun, Gumel, and Hadejia local government areas (LGAs) of Jigawa state had 86 (16.8%), 64 (12.6%), 48 (9.4%), and 44 (8.6%) respectively. The respondent's ages ranged from 1 − 100 years with a median age of 48 (interquartile range [IQR] = 31, 60) years. Chronic kidney disease (CKD) was found among 403 (79.2%) patients, acute on chronic kidney disease (AOCCKD) in 87 (17.1%) patients, and acute kidney injury (AKI) in 19 (3.7%) patients. The major risk factors identified were hypertension, diabetes, and chronic glomerulonephritis (CGN) among 329 (64.6%), 69 (13.6%), and 66 (13.0%) patients, respectively. Hypertension was a significantly higher risk factor among patients from Jigawa state compared with other states (46.8%,P< 0.001), hypertensives from Jigawa state were twice more likely to develop kidney disease requiring hemodialysis (adjusted odds ratio [aOR] = 2.2, 95% confidence interval [CI] = 1.7–2.8) compared with non-hypertensive etiologies.Conclusion:The burden of kidney diseases requiring hemodialysis in Jigawa state is high, with hypertension and diabetes being the major risk factors for hemodialysis. The government and other stakeholders should develop strategies for early identification and proper management of the risk factors.
Prevalence and Pattern of Premenstrual Syndrome among Secondary School Students in Kaduna State
Authors: Suleiman Aisha , Yahya Anisah , Oguntayo Adekunle O. 
Published: August 2024

Context:
Menstruation may be associated with somatic and psychological symptoms of premenstrual syndrome.

Aims:
We determined the awareness, prevalence, and pattern of premenstrual syndrome among female students in secondary schools in Kaduna state. Association of premenstrual syndrome with sociodemographic profile of respondents and healthcare evaluation and intervention sought by students with premenstrual syndromes were also explored.

Materials and Methods:
It was a cross-sectional observational study conducted on 300 students enrolled in secondary schools in Sabon Gari Local Government Area in Kaduna state. A pretested questionnaire was used to obtain data. The data were analysed using SPSS 20 with P < .05 considered as significant.

Results:
The mean age of participants was 16.2 ± 1.6 years. The prevalence of premenstrual syndrome was 226 (75.3%). Dysmenorrhea was the most common physical manifestation of premenstrual syndrome and occurred in 183 (81.0%) of the respondents with premenstrual syndrome with a median pain score of 3.0, while mood swings were the most common emotional manifestation of premenstrual syndrome present among respondents 132 (58.4%). Healthcare evaluation was sought by only 15.4% of those affected; however, a good number (42.5%) sought for some form of intervention for their symptoms. There was no significant association between the occurrence of premenstrual syndrome and the sociodemographic profile of the respondents.

Conclusion:
The self-reported prevalence rate of premenstrual syndrome among the study population is high with dysmenorrhea being the most common symptom. There was no association found between the occurrence of premenstrual syndrome and sociodemographic profile of those affected. Most of the students affected did not seek for any form of healthcare evaluation.
Routine Immunization Uptake and Knowledge of Caregivers in Selected Rural Communities in Northwestern Nigeria
Authors: Ameen Hafsat A. , Musa Shehu , Ibraheem Rasheedat M. , Oladiji Femi , Musa Omotosho I. , Salaudeen Adekunle G. 
Published: August 2024

Context:
Childhood immunization remains a public health problem in Nigeria, as the status did not improve substantially during the last two decades, especially in northern Nigeria. Understanding the level of routine immunization uptake of children among caregivers is important if a healthy community is to be maintained.

Aim:
This study aimed to investigate the knowledge and level of routine immunization uptake among caregivers in Bukkuyum Local Government of Zamfara State, Nigeria.

Settings and Design:
A descriptive cross-sectional study involving 320 caregivers selected using a multistage sampling technique was conducted.

Materials and Methods:
Sociodemographics, vaccination details, and knowledge were obtained via a semi-structured interviewer-administered questionnaire.

Statistical Analysis Used:
Data collected was analyzed using Statistical Package for Social Sciences (SPSS) statistics for Windows, version 21.0.

Results:
Findings show abysmally low levels of uptake of routine immunization antigens, namely, Bacille Calmette- Guerine (BCG) (26.1%), Oral Polio Vaccine LGAs= Local Government Areas (OPV) (42.5%), pentavalent vaccine (18.9%), and measles (13.0%). Only 80 (25.0%) children were fully immunized, 93 (29.0%) partially immunized, and 147 (46.0%) nonimmunized. Most respondents had poor knowledge (308 (96.2%)) and poor attitudinal disposition (173 (54.1%)) toward routine immunization.

Conclusion:
The vaccination uptake and knowledge of immunization among caregivers in the study area are poor. Caregivers' continual health education and a step-up of mobile health education activities by healthcare providers are crucial to improve routine immunization uptake in the study area.
Improving Access to HIV/AIDS and Sexual and Reproductive Health Information and Services among Adolescents with Hearing Impairment in Ibadan, Nigeria: Protocol for a Pilot Cluster Randomized Controlled Trial
Authors: Adebayo Emmanuel , Olumide Adesola , Olaniyan Halimat , Oluwagbayela Babatunde 
Published: August 2024

Context:
Adolescents with hearing impairment are generally neglected in the design and implementation of most HIV information interventions. However, this group of adolescents significantly contributes to the rising incidence of HIV among adolescents.

Aim:
This study presents the protocol for a study that pilots an intervention to provide Sexual and Reproductive Health (SRH) and HIV information for adolescents with hearing impairment.

Settings and Design:
The study will be a cluster randomized control trial. The study will be conducted in two phases.

Materials and Methods:
Phase one will include information gathering about the current services available to adolescents generally and adolescents with hearing impairment across selected primary healthcare centers. The information obtained during this will be used to design the intervention. Phase two will be a pilot of the intervention to increase the comprehensive knowledge of HIV among adolescents with hearing impairment and link them to existing services. A pre-post intervention survey will be conducted to measure knowledge of SRH and HIV among the participants. Post-intervention surveys will occur immediately after and one-month post-intervention.

Conclusion:
This study will provide baseline information for a more robust study on improving access to information and services among adolescents with hearing impairment.
Childhood cataract in Indian subcontinent: Challenges and strategies
Authors: Parija Sucheta , Mahajan Preetam B , Kar Anmol 
Published: August 2024

Abstract
Cataracts in children are one of the leading causes of visual impairment and if not treated timely have an impact on the neurobiological development of the child, leading to amblyopia. Cataracts in children are either congenital, developmental, or traumatic. A comprehensive ocular, systemic examination, age of onset, morphology, and laterality of cataracts are essential factors to be considered during management. Innovations, technology, and expert surgical techniques have made surgery uneventful with good visual outcomes. In this article, we summarize the current situation, barriers, challenges, and recommendations for the management of congenital cataracts in India. Strategies for managing congenital cataracts must be adapted and developed according to regional conditions. A basic framework for acceptable outcomes must focus on developing systems to address the critical components of education, access, quality care, and good follow-up.