bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing Treatment Efficacy and Determinants of Outcome in Isoniazid Mono-resistant Tuberculosis Patients: A Prospective Observational Study in Gujarat
Authors: Patel Keyur , Yogesh M. , Makwana Manju , Misra Swati 
Published: April 2024

Introduction:
There is a high number of isoniazid-resistant tuberculosis (TB) in India; estimates imply that over 25% of TB patients there are isoniazid-resistant. Hence, the study aimed to evaluate the effectiveness of therapy for patients with isoniazid-mono-resistant TB and the negative effects of the H-mono-resistant TB Regime.

Materials and Methods:
It was a hospital-based prospective observational study from September 2021 to August 2022. Hence, 100 patients diagnosed with isoniazid mono-resistance TB enrolled in this study. After obtaining the prior informed consent of all patients willing to approve the collection and publication of their data, including extensive clinical history and radiological, microbiological, and biochemical investigations, this study included all diagnosed cases of isoniazid mono-resistant TB. A descriptive statistical analysis was done for continuous and categorical variables. Differences in characteristics between participants were tested with logistic regression and cross-tabulation. P <0.05 was considered significant.

Results:
Among 100 patients participated, their mean age was 50.8 ± 3.2 years. About 72 (72%) participants have successful treatment outcomes (cure). Only about 25 (25%) patients had minor adverse drug reactions. Body mass index (16.6 [3.6–74]), substance addiction history (9.5 [3.3–26.9]), previous history of TB (9 [3.3–24.0]), type of lesion (5.3 [1.6–17]), and extent of the lesion (2.6 [1.03–6.07]) in chest X-ray were associated statistically with the treatment outcome.

Conclusion:
The findings suggest that the H-mono-resistance regime is generally well-tolerated, with only a small percentage of patients experiencing nonserious adverse drug reactions, and the overall successful treatment outcome in H-mono patients was 72%. The study also highlights the importance of monitoring drug resistance patterns, particularly for levofloxacin and moxifloxacin, and the need for effective treatment regimens for isoniazid mono-resistant pulmonary TB.
A rare complication of measles infection presented with subacute sclerosing panencephalitis: Report of two cases in India
Authors: Fatima Razeen , Husain Amir , Tabish Iram 
Published: April 2024

Rationale:
Subacute sclerosing panencephalitis (SSPE) is a progressive neurological disorder caused by persistent measles virus infection. SSPE predominantly affects children and adolescents. The symptoms usually develop 6-15 years after measles infection and ultimately leading to death in many cases.

Patient concerns:
Patient 1 presented with cognitive decline and myoclonus and the Patient 2 presented with diminution of vision with myoclonic jerks.

Diagnosis:
Based on the clinical features with a characteristic electroencephalogram pattern and the presence of a high titer of anti-measles IgG in serum and cerebrospinal fluid, these patients were diagnosed as SSPE.

Interventions:
Antiepileptics were started for controlling myoclonus along with supportive treatment.

Outcomes:
Both patients were discharged on antiepileptics and supportive care.

Lessons:
Whenever there are unusual clinical manifestations with unknown vaccination status, SSPE can be suspected and the cerebrospinal fluid should be examined for anti-measles antibodies. Our case study also highlights the importance of universal coverage of measles vaccination. To reduce the incidence of measles and associated deaths, it is important to maintain a high level of immunization coverage for the measles vaccine and to strengthen all the integral components of the national immunization program.
Prognostic value of N–terminal pro B–type natriuretic peptide and troponin I in children with dengue shock syndrome
Authors: Truyen Phuoc Le , Nguyen Phung Nguyen The 
Published: April 2024

Objective:
To investigate the contribution of N-terminal pro B-type natriuretic peptide (NT-pro BNP) and troponin I to mortality in children with dengue shock syndrome.

Methods:
A longitudinal study was conducted on children with dengue shock syndrome in a hospital in southern Vietnam. Detailed clinical histories, physical examinations, and laboratory parameters, including NT-pro BNP and troponin I, were recorded. A comparison between survival and non-survival was carried out to identify factors influencing mortality.

Results:
A total of 107 patients with a median age of 9 years were included in the study. Among them, 63.6% (68/107) presented with compensated shock, 36.4% (39/107) had hypotensive shock, 23.4% (25/107) required mechanical ventilation, and 12.1% (13/107) died. The NT-pro BNP levels were 3.9 pmol/L (IQR: 1.9, 10.3) and 15.2 pmol/L (5.8, 46.3), while the median high sensitivity troponin I levels were 20 pg/L (6, 95) and 62 pg/L (12, 325) at the first and second measurements, respectively. The mortality group exhibited higher rates of hypotensive shock, prolonged shock, lactate levels, liver damage, NT-pro BNP, and troponin I levels. Hypotensive shock (OR 12.96, 95% Cl 2.70-62.30, P=0.004), prolonged shock (OR 39.40, 95% CI 6.68-232.70, P<0.001), AST > 1 000 IU/L (OR 9.50, 95% CI 2.63-34.34, P=0.041), and NT-pro BNP > 7 pmol/L (OR 44.40, 95% CI 5.44-362.20, P=0.001) were identified as predictive factors for mortality in dengue shock syndrome.

Conclusions:
The NT-pro BNP level could serve as a potential biomarker for predicting mortality in children with dengue shock syndrome.
Systemic Lupus Erythematosus Patients in the Qassim Region, Saudi Arabia: Insights on Peripheral Nervous System Involvements
Authors: Alrashdi Mousa Nasser , Alharbi Aeshah Menawer , Algubllan Lamees A. , Alrasheedi Sami M. , Alkhdairi Ahmad , Alzweihary Ali M. , Alrumayh Fahad Mansour , Alhemedy Areen Mohammad , Alrasheedi Ibrahim Mohammad , Alrashidi Yousef Duhaim Abdulrahman , Alorini Rasha Mohamed , Alobaid Njood Mohammed 
Published: April 2024

Background:Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with diverse clinical manifestations. This study aimed to investigate the prevalence, clinical features, and risk factors associated with peripheral nervous system (PNS) involvement in SLE patients.Materials and Methods:This study encompassed a retrospective analysis involving 377 SLE patients diagnosed according to the European Alliance of Associations for Rheumatology/American College of Rheumatology criteria at Qassim region in Saudi Arabia, conducted through a meticulous chart review facilitated by proficient data collectors. A structured data collection form/checklist, incorporating explicit definitions and instructions, was utilized for extracting information from patient files, papers, and databases. Additionally, the SLE Quality of Life Questionnaire was employed to evaluate the quality of life among the participants. A multivariate logistic regression model was employed to identify independent predictors of PNS involvement.Results:Distinct clinical patterns were observed in SLE patients with PNS involvement, including a higher prevalence of nonscarring alopecia, acute cutaneous lesions, oral ulcers, and seizures. Diabetes and chronic kidney disease emerged as significant positive predictors for PNS complications. Hematological abnormalities, renal involvement, and vitamin deficiencies were prevalent, contributing to an overall poor quality of life among these patients.Conclusion:This study underscores the need for heightened clinical awareness of PNS complications in SLE, emphasizing the impact of diabetes and chronic kidney disease as significant risk factors. Early detection and targeted interventions are crucial to improving outcomes and enhancing the overall quality of life for SLE patients with PNS involvement.
Utility of sUPAR as a Novel Biomarker for Stratifying Rheumatoid Arthritis Patients in Remission
Authors: Kakar Atul , Choudhury Sangeeta , Chaturvedi Ved , Tripathi Shikhar , Rajput Pooja Rani , Hasan Rizwana 
Published: April 2024

Introduction:
Soluble urokinase plasminogen activator receptor (SuPAR) is a novel biomarker studied in conditions such as infections and malignancies. There is a paucity of data on suPAR levels in patients in RA clinical remission. A hypothesis-driven study was conducted to determine the level of suPAR, which will aid in the stratification of patients in remission.

Methodology:
This observational pilot study included 48 subjects (24 rheumatoid arthritis [RA] patients in clinical remission as per the American College of Rheumatology criteria and 24 age-matched healthy individuals). 28-Joint Disease Activity Score (DAS28) calculator was used to calculate disease activity. Erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and plasma suPAR levels were assessed using suPARnostic® ELISA Assay kit (ViroGates, Denmark). The inflammatory parameters such as CRP, ESR, and suPAR were recorded at the time the patients were defined to be in clinical remission.

Results:
The median of suPAR level among cases in remission was 4.94 ng/mL and in controls was 3.54 ng/mL. The level of serum suPAR among RA remission patients was significantly higher (P < 0.001) than in healthy individuals (P < 0.001). The median of DAS28 score was 2.10, ESR 23, and CRP was 2.66. Nonparametric analysis (Spearman’s rho test) showed a significant correlation (P = 0.008) between DAS28 and ESR. The receiver operating characteristic showed area under the curve of 0.954 with sensitivity 83.3%, specificity 100%, negative predictive value 84%, and positive predictive value 100%.

Conclusion:
High suPAR levels among patients with clinical remission of RA demonstrate that these patients do possess baseline inflammatory status and hence continued treatment is required despite normal to mild range of ESR, CRP, and/or DAS 28 score. Thus, suPAR is a prognostic biomarker that can aid in better therapeutic management to patients with RA remission.
Cerebrospinal fluid biomarkers of demyelination in pediatric population
Authors: Metwally Hussein M.H. , El-Sheshiny Ahmed Hassan , Ahmed Ali M. , Attalla Hams A. 
Published: April 2024

Back
ground Many cerebrospinal fluid (CSF) biomarkers were reported to be associated with demyelinating diseases in adults. Some of these biomarkers are chitinase 3-like 1 (CHI3L1), oligoclonal bands, and neurofilament light chain (NFL). We aimed to investigate the association of CSF CHI3L1 and NFL with demyelination disorders in pediatric patients.

Patients and methods
All children with age less than 18 years who came to our department with possible demyelinating of neuroinflammatory disorder from the duration between 2009 to 2019 were included in the study. Enzyme-linked immunosorbent assays were used for the analysis of the needed values.

Results
The data of 97 children were retrieved, and they were categorized as follows: patients with a demyelinating disease (n=17), patients with inflammatory neurological disorders (n=25), patients with systemic inflammatory disorders (n=9), patients with other neurological disorders (n=28), and normal pediatric population (n=18). There was a significant difference between these groups regarding the CSF level of CHI3L1 and NFL, as they were significantly higher in demyelinating disorders rather than other groups.

Conclusion
The levels of CHI3L1 and NFL in the CSF showed the diagnostic value in demyelinating disorders of pediatric populations and would be effective in distinguishing between different demyelinating disorders.
Study the role of dyslipidemia in cases of neuropathy with type 2 diabetes mellitus
Authors: Ali Hossam Abd El Monem , Al Adl Ahmed Salama 
Published: April 2024

Background
Diabetic neuropathy is one of the most common neurological diseases. Dyslipidemia is very common in diabetic patients and thought to add to the effect of diabetes on peripheral nerves.

Objectives
To assess the effect of dyslipidemia on diabetic peripheral neuropathy among patients with type 2 diabetes mellitus.

Patients and methods
A total of 60 patients with peripheral diabetic polyneuropathy were included and divided into two groups: the first included 30 patients with diabetic neuropathy and dyslipidemia and the other 30 patients had diabetic neuropathy without dyslipidemia. Another 30 healthy volunteers were included as a control group. All were subjected to full history taking, clinical examination, laboratory investigations, and neurophysiological studies.

Results
Hypertension and smoking were significantly increased in cases when compared with controls. Regarding the severity of neuropathy, it was mild in seven (11.7%) patients, moderate in 34 (56.7%) patients, and severe in 19 (31.7%) patients. Neurophysiological studies of the studied populations revealed significant changes of both motor and sensory parameters in cases when compared with controls and in the group with dyslipidemia when compared with the group without dyslipidemia. In addition, there was a significant correlation between lipid profile and each of glycated hemoglobin, fasting and postprandial blood sugar, and different neurophysiological examinations.

Conclusion
Dyslipidemia added to the hazardous effect of diabetic neuropathy on neurophysiological studies. In addition, there was a significant correlation between lipid profile and changes in nerve conduction studies.
Psychological changes of a sample of morbid obese patients before and after bariatric surgery
Authors: Hammouda Safaa M. , Elaziz Shaimaa Y.A. , El-Rahman Abo Sena Kamal A. 
Published: April 2024

Objective
Morbid obesity (defined as a BMI>40) is a severe condition in developing countries. Morbid obese patients are at high risk for psychiatric and psychological dysfunctional disorders. Moreover, many of bariatric surgery candidates experience mood disorders, anxiety, and eating disorders after bariatric surgery.

Patients and methods
Psychological assessment was done using the Arabic version of structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition axis I disorders for 70 morbid obese patients (22 males and 48 females), with mean age of 36.57 years, at Al-Zahraa University Hospital, before they underwent bariatric surgery. Psychiatric reassessment for the same patients was done 6 months later after the operation.

Results
The prevalence of psychiatric disorders among 70 morbid obesity participants who underwent obesity surgery was 48.6%, depression was 45.71%, anxiety was 12.86%, and eating disorders (binge eating) was 11.43% before surgery, whereas reassessment 6 months after surgery by reusing Arabic version of structured clinical interview for Diagnostic and Statistical Manual of Mental Disorders, fourth edition axis I disorders showed decrease in psychiatric disorders by 20.6%, decrease in diagnosis of depression by 37.5%, and eating disorders, especially binge eating, by 62.5%, but no difference in anxiety.

Conclusion
The results highlight the importance of psychological assessment and counseling before and after bariatric surgery to help patients to achieve their goal of losing weight and improve their quality of life after surgery.
Assessment of sexual dysfunctions among newly married couples in Egypt
Authors: Mohamed Mohamed Essam El-Den , Abdel-Aleem Hazem L. , Hamdy Ahmed G. 
Published: April 2024

Background and Aim
Unconsummated marriage is a problem among couples who are not able to perform natural sexual intercourse. The aim of this work was to define the etiological factors of unconsummated marriage in newly married men.

Patients and methods
This is a case–control study that was carried out on 200 newly married men during the period between October 2019 and October 2020, comprising 100 men with sexual dysfunctions leading to unconsummated marriage as a case group and 100 men without any sexual dysfunctions having successful intercourse as a control group. They were evaluated through history taking, psychosexual questionnaires, general and local examinations, laboratory investigations (estimations of serum serum total and free testosterone, estradiol, prolactin, luteinizing hormone, follicle-stimulating hormone, fasting and postprandial blood glucose levels, and lipid profile), and penile duplex.

Results
Regarding sexual history, male c ause of unconsummated marriage was present in 82% of the patients in the form of erectile dysfunction (73% psychogenic and 9% organic, using penile dupplex), and the other 18% of the patients had history of female cause in the form of vaginismus. Psychosexual history showed that history of consulting scientific informative source concerning sexuality was present in only 3% of patients, history of refusing to look closely at the partner's genitalia was present in 4%, and history of being afraid of feeling pain during penetration was present in 9%.

Conclusion
Psychogenic erectile dysfunction was the most common etiological factor for unconsummated marriage. Vaginismus was found to be a major concern regarding unconsummated marriage as well. Lack of scientific information about sexuality was found to be a major risk factor for unconsummated marriage in newly married men.
The outcomes of tubularized incised plate hypospadias repair and tubularized incised plate grafting using muccal mucosal graft and preputial free graft
Authors: Mohammed Abdelnaser H. , Altramsy Ayman , Matar Adel , Elbakry Adel 
Published: April 2024

Objective
Hypospadias is the most common anomaly of congenital urogenital defects. Tubularized incised plate (TIP) repair is an established technique. High rates of its complication advocate the idea of grafting of TIP incision. Grafts may be buccal mucosa or prepuce in this study.

Patients and methods
This prospective study included 64 patients complaining of mid and distal penile hypospadias. The patients were randomized into three groups according to the technique used in the repair of hypospadias. The first group included patients repaired by TIP urethroplasty, whereas group B and group C included patients repaired by inner perpetual skin and buccal mucosa, respectively. Follow-up was for 6 months.

Results
This study included 64 cases. TIP repair (group A) was done for 20 patients, whereas in 44 cases, TIP grafting was performed; groups B and C included 21 and 23 cases, respectively. The TIP urethroplasty was successful in 85%, whereas in groups B and C, the success rates were 91.5 and 87%, respectively. There were statistically insignificant differences in complications among all groups (P>0.005).

Conclusion
Outcomes of TIP grafts have no significant difference than outcomes of TIP technique.
Panniculectomy during cesarean delivery
Authors: Abdelaty Walid R. , Taha Wael S. 
Published: April 2024

Background
Panniculectomy has frequently been asked by many women to be done in the same session as a cesarean section (CS), to remove excess skin and stretch marks that develop during pregnancy and gain the benefits from avoiding a future surgery and repeated anesthesia.

Aim
To evaluate the safety, the cosmetic results, and possible complications of combining panniculectomy with CS.

Patients and methods
This study included 50 pregnant women who underwent panniculectomy combined with CS. The study was conducted in Al-Hussain University Hospital, in Cairo, Egypt, during the period from April 2018 till February 2020, and had an average follow-up period of 6 months.

Results
This study showed that 24 (48%) patients were happy with the overall results. More than 50% of the cases had either postoperative complications or some unpleasant results. Persistent bulging of the abdomen and/or lack of waist definition (36%) were the most unesthetic result. Postoperative complications included infection (18%), wound dehiscence (9%), and distal skin necrosis (12%).

Conclusion
It may seem quite beneficial to combine the two surgical procedures in the same setting. However, owing to the higher risk of postoperative complications and unesthetic outcomes, it does not seem to be in the best interests of most patients.
Role of conventional magnetic resonance imaging and diffusion-weighted imaging in evaluation of breast lesions
Authors: Abdel-Raheem Mohammed Abdel-Fattah , Abdel-Samiae Hoda Abdel-Kareem , Ahmed Yasser Abdel-Aal , Sleem Moutaz Mahmoud 
Published: April 2024

Background and Aim
This study aimed to evaluate the role of diffusion-weighted imaging (DWI) and apparent diffusion coefficient in diagnosis of the breast lesions.

Patients and methods
This study included 100 patients referred to the Radiology Department of Al-Azhar Assiut University Hospital from February 2018 to May 2020 for DWI MRI examination with a provisional diagnosis of breast lesions. All patients were recruited after meeting the inclusion criteria. They underwent clinical examination, mammography, ultrasonography, and contrast-enhanced MRI with DWI.

Results
Our study included 100 cases. The combined MRI protocol of dynamic contrast-enhanced (DCE)-MRI and DWI was true positive in 60 and true negative in 30 patients. The combined MRI protocol of DCE-MRI and DWI provided a sensitivity of 92%, a specificity of 90%, a positive predictive value of 95.8%, a negative predictive value of 81.8% and accuracy of 91.43%. In this study, the addition of DWI to standard DCE-MRI provided a 10% increase in the specificity of breast MRI, with a 4% decrease in the sensitivity.

Conclusion
DWI is a short unenhanced scan and had the highest specificity compared with other imaging modalities, as it reduced the false-positive results. It should be added to conventional breast MRI to increase the sensitivity and specificity of MRI.
Chronic ethanol and tramadol interaction on the testicular tissues in adult male Albino rats
Authors: Gad Allaha Ahmed M. , Hemeda Mohamed S. 
Published: April 2024

Background and aim
In the developing and advanced countries across the world, young people have the tendency of consuming alcohol in combination with other abused substances. This study aimed to investigate the biochemical and histopathological effects of chronic toxic effects of two commonly abused substances, ethanol and/or tramadol, on testicular function in adult male Albino rats.

Materials and methods
Forty animals were equally divided into four groups: control group that received normal saline only, ethanol group that received ethanol [30% (v/v)] orally at a dose of 2 g/kg, tramadol group that received tramadol subcutaneously at a dose of 60 mg/kg, and ethanol+tramadol group that received ethanol+tramadol by the route and at the dose described above for 60 days. Twenty-four hours after the administration of the last dose, rats were sacrificed, blood samples were obtained, and serum testosterone was determined. Testes were harvested and weighed. Glutathione, superoxide dismutase, catalase, glutathione peroxidase, and malondialdehyde levels and histology (hematoxylin and eosin) were evaluated in the testis.

Results
Testosterone level, relative testicular weights, and testicular glutathione, catalase, superoxide dismutase, and glutathione peroxidase were significantly reduced in all experimental groups compared with controls. Conversely, malondialdehyde was significantly increased in all experimental groups compared with controls. Testicular histology in ethanol and/or tramadol showed structural aberrations that are consistent with antioxidant depletion and oxidative stress.

Conclusion
Abuse of ethanol and/or tramadol exerted similar, additive, and synergistic, adversely affected the male-reproductive functions, which may be due to the effects on the antioxidant-defense system and caused oxidative tissue injury as well as testicular structural aberrations.