bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metabolic acidosis as a predictor of outcome in critically ill children – A single-center prospective observational study
Authors: Datta Madhushree , Haldar Sanjay , Biswas Arnab , Sen Sandipan , Samanta Moumita , Mahapatra Tapan Kumar Sinha 
Published: May 2024

Background:
Acid-base disorders are common in critically ill patients and contribute significantly to mortality and morbidity. Metabolic acidosis (MA) can be measured by pH, base deficit, serum bicarbonate, and anion gap. A study was conducted to determine the incidence and type of MA among children admitted to the pediatric intensive care unit (PICU) and to assess its roles as a predictor of outcomes in them.

Subjects and Methods:
Over 1 year, 100 children between 1 month and 12 years of age who presented to the PICU with an MA or developed it within 24 h of admission were prospectively enrolled. Clinicodemographic data, pediatric sequential organ failure assessment score at admission, clinical outcome, and serial measurements of anion gap, serum lactate, and bicarbonate level were recorded.

Results:
The incidence of MA was 60.2% with a majority (52%) being high anion gap metabolic acidosis (HAGMA). The predominant condition (39%) leading to MA was catecholamine-resistant shock with organ dysfunction. Peak lactate value and bicarbonate nadir had a significant positive correlation with the duration of mechanical ventilation and inotropic support, but only peak lactate value was significantly associated with mortality. A peak lactate value of 2.19 mmol/L yielded the highest sensitivity and specificity for predicting mortality. There was no association was found between peak anion gap and morbidity or mortality.

Conclusions:
MA was observed in 60% of children in PICU, with HAGMA being the most common type. Peak lactate value and bicarbonate nadir were correlated with high morbidity, but only peak lactate value was significantly associated with mortality.
Exploring the scope of vlogs in strengthening the delivery of medical education
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh 
Published: May 2024

Abstract
With the passage of time, a number of curricular reforms have been introduced in the process of delivery of medical education. A video blog is a type of blog which utilizes the video medium to reach the audience. The purpose of the current review is to explore the role of video logs in strengthening the delivery of medical education. An extensive search of all materials related to the topic was carried out on the PubMed search engine and a total of 13 articles were selected based upon their suitability with the current review objectives and analyzed. Keywords used in the search include video blogs, and medical education in the title alone only. The video blogs have immense scope in the field of medical education, as it is one of an essential tool to promote student-centered learning, and enables the medical student to learn at their pace, and that too at their time of convenience. The need of the hour is that vlogs are integrated within the curriculum on a pilot basis, and research work is carried out to explore their benefit in terms of improving the attainment of knowledge and student engagement. Further, based on the obtained results, we can make modifications and eventually introduce vlogs in a structured manner in the curriculum. To conclude, vlogs are a widely used mode to share information on the online platform, nevertheless, it is high time that its utility is also explored and harnessed for improving the delivery of medical education. This calls for the need of all the stakeholders to take active steps and simultaneously plan for its inclusion and implementation in the teaching-learning process.
Prevalence of AcrAB-TolC efflux pump among Proteus mirabilis isolated from cystitis patients in Hilla City, Iraq
Authors: Al-Kaim Hawraa Wahab , Al-Dahmoshi Hussein O M 
Published: May 2024

Abstract

Background:

Proteus mirabilis is a prevalent profiteer pathogen that causes the Spartan human ailment. It has been identified as a urinary tract infection (UTI) etiological agent that adheres to uroepithelial cells and the catheter surface. The most important efflux system in P. mirabilis, acrAB-to1C, is elaborated not merely in antimicrobial conflict but also in ferocity.

Objectives:
The current research conducted to look into the antibiotic sensitivity profile and acrAB-to1C efflux pump genes occurrence among P. mirabilis isolated from UTI patients.

Materials and Methods:
515 urine cases were gathered from UTI patients, who visited urology consultancy clinics of three main hospitals and private clinic labs in Hilla City, Iraq. All mid-stream urine samples were cultured on diagnostic agars for P. mirabilis primary recognition and finally confirmed by16S rRNA gene PCR-sequencing. Antibiotic sensitivity was performed according to CLSI (2021), and then PCR detection of acrAB-to1C efflux pumps genes was observed.

Results:
The occurrence of P. mirabilis in the studied cases was 10.5% with 100% swarming isolates. The recovered isolates were extremely resistant to cefotaxime (100%), doxycycline (88.6%), minocycline (75.7%), and amoxicillin-clavulanic acid (67.1%). In contrast, the isolates showed nonresistance to pipracillin-tazabactam (0%), meropeneme (0%) and tinier resistance to amikacine (1.4%), imipeneme (2.9%), levofloxacine (4.2), and ofloxacin (5.7%), MDR rate was 96%. Molecular investigation using PCR, revealed acrA, acrB, and tolC genes with a prevalence of 51.4%, 61.4%, and 51.4%, respectively.

Conclusion:
These findings emphasize the significant title role of acrAB-to1C efflux impel in increasing antibiotic tolerance in P. mirabilis with a high incidence of MDR, so the future insights may need to focus on efflux pumps inhibitor-antibiotic combination treatment as a preventive device.
Knowledge of Mothers Regarding Management of Fever in their Children Under Five Years of Age in Al-Hilla City
Authors: Altahhan Raghad Abdulwahab Mohsen , Aljubbawi Sura Falah Abdulhadi 
Published: May 2024

Background:
Improper fever definitions will lead to excessive treatment with its adverse consequences, or missed fever, or delayed diagnosis of dangerous illness. Mothers’ care for a feverish child can sometimes be inappropriate and harmful.

Objective:
To assess knowledge of mothers regarding definition and management of fever in their children under five years of age and to identify the association between mothers’ knowledge and mothers’ socio demographic factors.

Materials and Methods:
A cross-sectional study was conducted among 302 mothers of alive children aged bellow five years. The mothers were interviewed (face-to-face) after giving their verbal consent to participate in this study by using a systematic questionnaire, which included mothers’ socio-demographic characteristics and questions related to fever management. It was carried out at Babylon Teaching Hospital for Maternity and Children, Al Imam Al Sadiq Teaching Hospital, and Al Noor Hospital For Children in Al-Hilla City, Iraq, from February 1 to June 15, 2022.

Results:
The mean age of mothers was (27.07 ± 6.33) years, 16.56% of mothers were higher education graduates, 86.75% were housewives. 0.66% of mothers had insufficient knowledge regarding fever management, 65.23% had moderate knowledge, and 34.11% had high knowledge. The mothers’ knowledge was in significant association with the mothers’ educational level, mothers’ occupation, using internet, and in significant negative correlation with number of alive children that the mothers had.

Conclusion:
About two-thirds of the mothers had moderate knowledge regarding fever management, about one-third had high knowledge, and less than one percent of mothers had insufficient knowledge.
Incidence of Acute Kidney Injury in Hospitalized COVID-19 Patients
Authors: Abdul Waheed Yasamine Abdul Hussein , Al-Shireefy Haider Mehdi Mueen 
Published: May 2024

Background:
Acute kidney injury (AKI) is common among patients hospitalized with COVID-19 and associated with worse prognosis.

Objective:
We aim to assess the incidence of AKI in hospitalized COVID-19 patients.

Materials and Methods:
This is a retrospective cross-sectional study conducted at Merjan Teaching Hospital from May 1 to October 1, 2021. It involved a review of data of 174 hospitalized polymerase chain reaction–confirmed COVID-19 patients from hospital health records.

Results:
In our hospitalized COVID-19 patients, AKI was found in 14 patients forming 8.05% of the total hospitalized patients. The age of participants with AKI was 62.64 ± 19.08 years; male patients formed the larger proportion (53.45%). More than one-third of the patients (36.21%) had a history of hypertension, and more than one-fifth of the patients had a history of diabetes mellitus (22.99%). History of ischemic heart disease was present in 4.60%, heart failure in 0.57%, asthma in 3.45%, chronic obstructive pulmonary disease in 1.15%, cerebrovascular accidents in 1.75%, and lung fibrosis in 1.15%. Patients with AKI had a significantly higher level of blood urea (22.44 ± 11.74); the level of serum creatinine was also significantly higher among patients with AKI (267.57 ± 87.27); significant relationship was observed between the outcome of the patient and the incidence of AKI.

Conclusions:
The current study showed a higher risk of mortality and morbidity in COVID-19 patients with AKI. Identifying high-risk groups and earlier diagnosis of AKI in COVID-19 patients can improve results in patients and decrease mortality.
Mother’s Perception Toward Childhood Diarrhea
Authors: Khazaal Abbas Abid , Yousif Miami Kadhim , Mousa Hasnah Abdelzahra 
Published: May 2024

Background:
Diarrheal disease is considered as the second most common cause of death among under-5 children globally.

Objective:
The aim of this article is to determine mothers’ knowledge and practices regarding diarrhea causes and principles of management.

Materials and Methods:
A cross-sectional study was conducted on 200 mothers of under-5 children who attended the pediatric outpatient department for diarrhea. The correlation between mothers’ age and level of education with their knowledge regarding signs of dehydration and their awareness of the use of oral rehydration solution (ORS) and management of diarrhea was done. The χ2 test was used, and a P-value of 0.05 was considered significant.

Results:
Nearly half (45%) of the mothers believed intestinal infection caused that diarrhea, whereas (37.5%) blamed the teething process. Mothers rated the severity of diarrhea as increased frequency (70%), change in consistency (62.5%), foul smell stool (13.5%), and change in stool color (7%). The study showed that 45% of the mothers did not know any sign of dehydration and indicated poor mothers’ adherence to ORS use (4%), despite their awareness of ORS (66.5%). The study showed a significant correlation between mothers’ education and initial management of diarrhea at home (P <0.05), but not with their awareness of ORS or their knowledge about signs of dehydration. There was no significant relation between mothers’ age and their awareness of ORS, their knowledge regarding the signs of dehydration, and their initial action to manage diarrhea at home.

Conclusion:
Most respondents lack satisfactory knowledge of diarrheal diseases. Therefore, mothers need health education to create a better attitude toward the prevention and management of diarrheal diseases.
Evaluating the Effect of Lemongrass Essential Oil Addition on Some Properties of Heat Cure Acrylic Soft-Lining Material
Authors: Naser Huda Jaafar , Abdul-Ameer Faiza M. 
Published: May 2024

Background:
Denture liners’ viscoelasticity absorbs shocks and relieves tissue pressure. Soft liners must be replaced every 6–12 months because oral conditions destroy elastomers. By adding chemicals to soft liners, researchers have created a new class of flexible, oral-friendly materials. This lowers denture and mucosa pressure.

Objectives:
The aim of the study is to discover if the best two concentrations of lemongrass essential oil (LGEO) added to heat-cured soft denture liner improves the material’s hardness, the strength of the peel bond, and surface roughness.

Materials and Methods:
In a pilot study, 2.5 vol.% and 5 vol.% LGEO improved the heat-cured soft-liner material’s Shore A hardness and surface roughness. The main study categorized 90 specimens into three groups (Shore A hardness, peel bond strength, and surface roughness). Each of the groups has three subgroups (control, 2.5 vol.% of LGEO additive, and 5 vol.% of LGEO additive). One-way analysis of variance, Dunnett’s T3 post hoc, Tukey’s honestly significant difference, and Fisher’s exact test were used for data analysis, which was significant at P < 0.05.

Results:
After adding 2.5 vol.% and 5 vol.% of LGEO additives (experimental subgroups), Shore hardness, peel bond strength, and surface roughness of the two experimental subgroups decreased significantly from the control subgroup at P < 0.05, except for 2.5 vol.% of the LGEO additive subgroup, which did not differ significantly at P > 0.05. When failure mode was assessed, all subgroups varied substantially. The 2.5 vol.% of LGEO addition specimens showed adhesive and cohesive failure with some mixed type, whereas 5 vol.% showed predominantly cohesive failure.

Conclusions:
LGEO enhances the hardness and surface roughness of the soft-lining material, making it more resilient and smoother. This leads to a greater cushioning effect and reduced damage to the oral tissues while decreasing the liner’s peel bond strength to an acceptable level. 5 vol.% is the best percentage that improves liner properties.
Association of mycoplasma pneumoniae and (rs9271366) HLA-DRB1gene polymorphism with the immune susceptibility to rheumatoid arthritis
Authors: Obaead Alfatlawi Wael Rasheed , Al-Saadi Mohammed A K , Ali Akbar Adil Hasan 
Published: May 2024

Abstract

Background:
Rheumatoid arthritis (RA) is a chronic, inflammatory disease that affects the immune system. The primary cause of RA is unknown, but there is evidence that genetic and environmental factors also contribute to the development of the disease.

Objectives:
This study aimed to illustrate the relationship between the RA and Mycoplasma pneumoniae.

Materials and Methods:
The work was performed on 50 RA patients of various ages, ranging from 25 to 75 years of age, who were treated at the rheumatology clinic of the city of Medical Marjan between February 2022 to October 2022.Blood samples were used for DNA extraction. HLA-DRB1, IL-6 and mycoplasma were detected by enzyme-linked immunosorbent assay (ELISA).

Results:
The results showed that compared with RA patients not infected with Mycoplasma pneumoniae and healthy subjects, serum IL-6 concentration was significantly increased in RA patients infected with Mycoplasma pneumoniae. The results showed that serum concentrations of HLADRB1 were significantly elevated in RA patients infected with M. pneumoniae compared with RA patients not infected with M. pneumoniae and healthy subjects.

Conclusions:
In HLA-DRB1 the SNP rs9271366 was significantly associated with RA and G allele represent as dominant pathogenic allele in which the individual that carry GG and AG genotype have more susceptibility to mycoplasma infection than subjects that carry AA genotype (P = 0.036).
Medical Aspect of Endoscopic Endonasal Transsphenoidal Hypophysectomy in Skull Base Center of Basra
Authors: Alali Mustafa H. , Obaid Firas T. , Abbasi Ahmed M. Al 
Published: May 2024

Background:
Endoscopic endonasal transsphenoidal (EETS) approach is a minimally invasive technique that has gained increased acceptability for the removal of sellar and para-sellar tumors.

Objectives:
To evaluate the EETH in the skull base center of Basra and compare our EETH procedures with others done in different centers.

Patients and Methods:
A prospective observational study was carried out in Basra skull base center at Al-Sader Teaching Hospital between August 2017 and July 2019, and it included 50 patients (29 female and 21 male) with a female to male ratio of 1.38:1. We included all patients with a pituitary tumor fit for surgery, and there were no exclusion criteria. The standard technique involved a unilateral, endoscopic, and endonasal approach to the sella turcica via an anterior sphenoidotomy, with enlargement of the natural sphenoid ostium using powered instrumentation and 0° and 30° rigid endoscopes for visualization. This was performed as a joint procedure by a consultant otolaryngologist and a consultant neurosurgeon.

Results:
The most common presenting symptom for pituitary tumor was headache, which is present in 80% (40 patients) of patients, followed by visual disturbance in 56% (28 patients). The MRI study of the brain and sellar region shows that 46 patients (90%) were diagnosed as having pituitary adenomas. Eighty-four patients present had a tumor larger than 1cm in size. Sixty eight percent (34 patients) had an abnormal hormonal study before the operation, whereas 32% (16 patients) had a normal hormonal analysis. Histopathological examination of the tumors showed pituitary adenoma in 90% (45 patients), followed by craniopharyngiomas in 6% (three patients) and 2% (one patient) was Rathke's cyst and 2% (one patient) was pituitary carcinoma. Postoperative follow-up result indicated headache improvement in 82% (34 patients), improvement in menstrual disturbance in 67% (13 patients), and vision improvement in 46% (13 patients). Seventy-four percent showed hormonal normalization after EETH, which is statistically significant (P < 0.05).

Conclusion:
This study show that endoscopic, endonasal, transsphenoidal hypophysectomy is a minimally invasive, effective, and safe procedure to remove pituitary tumors.
Assessment of Electroencephalographic Changes and Clinical Characteristics Among Patients with Substance-Related Disorder
Authors: Mubarek Zainab Walaa Sahib , Abbas Farah Nabil , Al-Agam Azher Nema Mohammed 
Published: May 2024

Background:Substance abuse is defined as the hazardous use of psychoactive substances such as alcohol and illegal narcotics. It is a significant global public health concern. Chronic relapsing diseases, defined by compulsive use of drugs despite negative health effects, were substantial contributors to the illness burden in the USA and all over the world.Objective:The objectives were as follows: (a) to determine the presence of electroencephalographic (EEG) changes and their types among patients with substance-related disorders and (b) to evaluate the sociodemographic and clinical characteristics of patients with substance-related disorder.Materials and Methods:It was a cross-sectional study conducted from September 1, 2021 to August 1, 2022. It was performed on 112 patients (104 males and 8 females) in the Neurophysiology Department of Al Imam Al Sadiq Teaching Hospital in Al-Hilla Governorate. The patients were diagnosed by psychiatrists, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. All patients were assessed by history, physical examination, and EEG test.Results:The study showed that the frequency of EEG changes was 57.1%, whereas those without any changes was 42.9%. Those with score 2 or moderate severity were 53.6%. Severe abnormalities were found in 3.5% of the patients. There was a significant association between the EEG change and the type of substance taken, with aP-value of 0.008. The study showed the association between the EEG change and duration of substance taken, with aP-value of 0.0001, which was significant. There was a significant association between the type of substance taken and age (P= 0.002). The association between the type of substance taken and gender, residence, and occupation was non-significant.Conclusion:The study concluded that the EEG changes were of high prevalence in patients with substance-related disorder. The most common abnormality was score 2 (moderate severity). The most common substance with an abnormal EEG change was amphetamine.
The Role of Asprosin and Ceramides in the Development of Growth Hormone Deficiency in Children
Authors: Al-Jubawi Muntadher Mohammad , Mohammed Seenaa B. , Al-Abedi Rihab F. 
Published: May 2024

Background:
Growth hormone deficiency (GHD) is an endocrine condition, which is defined as a reduction in growth hormone (GH) synthesis; this study aims to evaluate the level of asprosin and ceramides in children (patients) with idiopathic isolated GHD.

Materials and Methods:
The present study was designed as a case–control study; 43 patients (24 males and 19 females) with idiopathic isolated GHD were involved in this study. Forty-five subjects (26 males and 19 females) who were apparently healthy control that enrolled in this study were matched with patients of the same sex and age.

Results:
The present study revealed a significant decrease (P < 0.05) in the levels of asprosin, ceramides, and glucose in patients with GHD when compared with its control group.

Conclusions:
Asprosin may be one of the underlying causes of GHD through its indirect role in releasing GH. GHD may decrease the level of ceramides by the effect of GH on lipid metabolism.
Study of Serum Chitinase-3-like-1 Protein (CHI3L1) and C-reactive Protein (CRP) in Patients Suffering from Chronic Plaque Psoriasis
Authors: Al-Saba Ahmed Hassan , Shemran Khawla Abdulhamza , Al-Hattab Mohammed K. 
Published: May 2024

Background:
Psoriasis is a chronic inflammatory disease marked by the formation of well-defined raised erythematous plaques on the skin surface with silvery white scales. Chitinase-3-like-1 protein (CHI3L1) is thought to be important in physiological and pathological processes including angiogenesis, mitogenesis, and remodeling. C-reactive protein (CRP) has been suggested as an inflammatory biomarker in psoriasis and other disorders.

Objectives:
The aim of the current study is to determine the serum levels of CHI3L1 and CRP in psoriasis patients and to compare with healthy controls. In addition, the present study aims to investigate which is more sensitive and specific for diagnosing psoriasis.

Materials and Methods:
This is a case–control study. Sixty patients were involved in this study, divided into two groups (severe group that contains 30 patients and moderate group that contains 30 patients). Thirty individuals apparently healthy as control subjects were involved in the current study and all of them without any skin disease or other autoimmune diseases.

Results:
The current study revealed a significant increase in the serum CHI3L1 and CRP among psoriatic patients when compared with healthy controls.

Conclusion:
CHI3L1 and CRP increase with increased severity of psoriasis disease. CHI3L1 was a more sensitive and specific biomarker than CRP, according to the area under the curve in the receiver-operating characteristic curve test. Therefore, it is a good marker for the diagnosis of psoriasis patients.