bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pupil cycle time and its significance in patients with diabetic retinopathy
Authors: Kalita Prasenjit , Gogoi Ankita , Bhuyan Jyoti , Boro Manjit 
Published: May 2024

Context:
Prolonged pupil cycle time (PCT) is a complication of type II diabetes and becomes more protracted as the disease progresses. PCT can be used as a quick and accurate clinical test to determine how much autonomic neuropathy is influencing a diabetic patient’s pupil.

Aims:
The aim of the study was to compare the PCT of type II diabetes patients with that of the healthy control group and analyze the impact of several factors, including age, sex, duration of diabetes, and grade of diabetic retinopathy on PCT.

Settings and Design:
The study was conducted from August 2022 to August 2023. One hundred people were arbitrarily selected, 50 of whom had diabetes and 50 healthy controls.

Subjects and Methods:
To start rhythmic cycles of contraction and relaxation, a narrow, horizontally aligned beam of fixed proportions was focused on the inferior area of the pupil. The cycle period was then monitored in milliseconds using a handheld stopwatch. The mean PCT of diabetics was compared with nondiabetics and its correlation with different variables such as age, sex, diabetes duration, and grade of retinopathy was done.

Results:
Fifty diabetic patients (28 females and 22 males) aged 42–74 years and 50 controls (32 females and 18 males) aged 44–70 were included in the study. The mean PCT of the diabetics was 1130 ± 186 ms, whereas it was 940 ± 132 ms in the controls; thus, the mean PCT was longer in the diabetics. It was also found that the mean PCT increased with increasing grades of retinopathy. A positive correlation was also noted between mean PCT and duration of diabetes.

Conclusions:
PCT is a fast, simple, and reliable clinical test of optic nerve function. Being objective and quantifiable for each eye separately is a huge benefit. The PCT measurements might be used in the clinical evaluation of an autonomic nervous system. It is a simple, inexpensive yet quick, and effective tool to assess pupillary autonomic neuropathy in the diabetics.
Typical cytomegalovirus retinitis in non-human immunodeficiency virus partially immunosuppressed patients: A case series
Authors: Singh Alok Pratap , Pandharipande Archit Sunil , Ojha Anubha , Yadav Sanjeev , Behera Manas R. , Sharma Kumudini 
Published: May 2024

Purpose:
The purpose of the study was to analyze the occurrence of severe, typical cytomegalovirus (CMV) retinitis (CMVR) in human immunodeficiency virus (HIV) negative, partially immunosuppressed patients, emphasizing inconsistency in the clinical presentation of CMVR and to evaluate the role of combined anti-CMV therapy in the management of such patients.

Materials and Methods:
This study was a retrospective, observational, noncomparative case series. We examined and treated consecutive HIV-negative adult patients of CMVR. Blood-based polymerase chain reaction analysis of the CMV genome was done pre- and posttreatment. Details of underlying systemic conditions were collected. Patients were treated with simultaneous administration of intravitreal and intravenous (IV) anti-CMV therapy. Follow-up was for 1 year. All outcomes were determined retrospectively.

Results:
A total of 6 eyes of 4 consecutive patients were diagnosed with CMVR in HIV-negative patients. Patients were only partially immunosuppressed but revealed typical severe fulminant CMVR. Patients received a total of 2 intravitreal ganciclovir injections, and IV ganciclovir/oral valganciclovir was given. All patients achieved complete healing within the treatment period.

Conclusion:
As opposed to the general perception, typical, fulminant, severe CMVR may occur in patients with limited immune dysfunction. Our report underlines this inconsistency in the clinical presentation of CMVR in partially immunosuppressed patients. The immune status of the patients seems a significant factor in determining the clinical phenotypes of CMVR. Combined intravitreal and IV ganciclovir/oral valganciclovir therapy was successful in treating this group of CMVR patients.
Clinical study of ocular manifestations in patients with newly diagnosed and relapsed hematolymphoid malignancies at a tertiary care hospital
Authors: Honniganur Deepthi Rameshbabu , Pradeep Thanuja Gopal , Devadas Santhosh Kumar 
Published: May 2024

Objectives:
To estimate the proportion of ocular manifestations in new and relapsed cases of various hematolymphoid malignancies and to determine an association between these ocular manifestations and the hematological parameters of the patients.

Materials and Methods:
The study was conducted in the department of ophthalmology in association with medical oncology. All patients with newly diagnosed or presenting with a relapse of hematolymphoid malignancies underwent a complete ocular evaluation.

Results:
A total of 63 patients were included in this study. The mean age of the patients was 34.71 ± 19.80 years. Acute myeloid leukemia and B-ALL accounted for 73% of the cases. At the time of examination, 47.61% of patients (n = 30) were newly diagnosed and 52.38% (n = 33) had relapsed. Acute leukemias had more probability of having ocular manifestations than chronic leukemias (P = 0.01). Subconjunctival hemorrhage was found to be the most common anterior segment finding (n = 10, 15.87%; P = 0.05). The most common posterior segment finding seen in both the right and left eyes was dot blot hemorrhages (n = 20). Those patients who had hemoglobin counts <6.5 mg/dl had the most ophthalmic manifestations (n = 20); of which Roth spots were seen the most (n = 6; P = 0.04). And those who had platelet counts <50,000 cells/cumm presented with Roth spots (n = 6, P = 0.05) followed by subretinal hemorrhages (n = 5, P = 0.05) and preretinal hemorrhages (n = 5, P = 0.05).

Conclusion:
Screening to detect ocular manifestations is of importance in hematolymphoid malignancy, especially in newly detected and relapsed cases. A complete ocular examination is recommended in these patients, as most patients are asymptomatic and ocular manifestation could be an early sign of worsening of the disease. Among the various blood parameters, low hemoglobin and platelet counts are definite indicators of the presence of intraretinal bleeding manifestations.
Prevalence of acute low back pain with risk of long-term disability and its correlates among medical students: A cross-sectional study
Authors: Shekhar Saket , Rao Rajath , Nirala Santosh Kumar , Naik Bijaya Nanda , Singh Chandramani , Pandey Sanjay 
Published: May 2024

BACKGROUND:
Low back pain (LBP) is responsible for the highest number of years lived with disability globally. There is a paucity of data regarding the same among medical students. So, this study was planned to estimate the prevalence of acute LBP having a high propensity to develop into chronic one as well as to determine associated correlates among medical students.

MATERIALS AND METHODS:
This cross-sectional study was conducted among 300 medical students at a tertiary hospital using an Acute Low Back Pain Screening Questionnaire (ALBPSQ) to identify individuals with LBP and having a high risk of developing a long-term disability. ALBPSQ is a 21-question-based biopsychosocial screening instrument for identifying patients at risk of chronicity. ALBPSQ scores have been found to be significantly associated with pain and functional disability. Descriptive statistics, bivariate analysis, and multiple binary logistic regression have been performed through SPSS-22 software.

RESULTS:
The prevalence of LBP having the propensity to develop into a long-term disability was found to be 14.3% (95% CI: 10.6–18.8). In bivariate analysis, higher age, no exercise, higher screen time, mental stress, studying in bed, abnormal posture, alcohol intake, tobacco use, positive family history, greater screen time per day, and more time spent in a sitting posture are significant with LBP. Stress ((adjusted odds ratio) AOR: 4.37, 95% CI: 1.79–10.68)), abnormally bent standing posture (AOR: 3.6, 95% CI: 1.3–10.6), and positive family of LBP (AOR: 3.6, 95% CI: 1.3–10.1) were found to be independent predictors of LBP among medical students.

CONCLUSION:
Among medical students, every 15 out of 100 have a low back problem with chances of long-term disability. These students require early intervention to avoid long-term disability. Abnormal stooping posture, psychological stress, and positive family history of low pain might independently lead to LBP.
Nursing students and faculty perception of academic incivility: A descriptive qualitative study
Authors: Ehsani Maryam , Farzi Sedigheh , Farzi Fatemeh , Babaei Sima , Heidari Zeinab , Mohammadi Fatemeh 
Published: May 2024

BACKGROUND:Incivility is one of the significant challenges that affect nursing education. Uncivil behaviors have a significant upward trend compared to the past in nursing education. This study was conducted to explore academic incivility from the perspective of nursing students and faculty.MATERIALS AND METHODS:This study was conducted in 2021 using a descriptive qualitative method. Fifteen baccalaureate nursing students and six faculty were selected using purposeful sampling method. Data was collected through in-depth semi-structured interviews, and a qualitative content analysis was applied for data analysis.RESULTS:Data analysis revealed four categories, namely, ineffective teaching–learning, inapposite/unreasonable requests, behaviors disrupting mutually respectful environment, and academic dishonesty, and 14 subcategories.CONCLUSION:To reduce incivility, closer attention needs to be paid to the admission of faculty as well as training them to use effective communication techniques and interactive teaching methods. In addition, nursing students must be provided with the training about uncivil behaviors. Furthermore, clear and precise rules and regulations concerning incivility incidence should be developed and implemented in the universities.
Requirements for promoting help-seeking behaviors in family caregivers of cancer patients: A qualitative study
Authors: Hamedani Behzad , Alavi Mousa , Taleghani Fariba , Fereidooni Moghadam Malek 
Published: May 2024

BACKGROUND:
Caring for a family member with cancer is a challenging issue for families. Family caregivers often need the help of supportive resources to solve problems in their care role. A deep understanding of the requirements of caregivers to seek help is an effective step toward their ability to use supportive resources. This study aimed to identify and describe the requirements for promoting help-seeking behaviors in Iranian family caregivers of cancer patients.

MATERIALS AND METHODS:
This qualitative study was conducted through in-depth semi-structured interviews with 28 participants selected using purposeful sampling method from 2019 to 2021. An interview guide with general questions about seeking help was used to maintain coherence in data collection. The interviews continued until data saturation. All interviews were recorded, transcribed and analyzed through qualitative content analysis.

RESULTS:
The requirements of promoting help-seeking behaviors in family caregivers were grouped into four main categories: (1) improving social paths toward seeking help, (2) spiritual-psychological-cognitive empowerment toward seeking help, (3) strengthening the motivations behind seeking help, and (4) modifying the perception of cultural barriers to seeking help.

CONCLUSION:
According to the results of this study, it is expected that by identifying the requirements of caregivers for seeking help and by health stakeholders designing comprehensive programs to address these needs, caregivers will be empowered to use supportive resources and provide a better care role.
Facilitators of improving the function of nongovernmental organizations (NGOs) in Iran's health system
Authors: Rajabi Mohanna , Ebrahimi Parvin , Aryankhesal Aidin 
Published: May 2024

BACKGROUND:
Iranian health nongovernmental organizations (NGOs) could play a variety of roles at many levels of Iran's health system, but their participation in the health sector is far from ideal. Therefore, this study was conducted to identify practical solutions for increasing the role and function of NGOs in the Iranian health system.

MATERIALS AND METHODS:
This qualitative study was conducted between 2020 and 2021 in Tehran, Iran. The data for this study were gathered through 32 in-depth semi-structured interviews with 11 managers from the Ministry of Health as well as from Iran and Tehran universities of medical sciences and 21 Chief executive officers and directors of health NGOs. Data were analyzed by the content analysis approach using the MAXQDA 10 software.

RESULTS:
The facilitators for expanding the function and roles of NGOs in Iran's health system are classified into two groups of legal and structural mechanisms. “The existence of mandatory laws,” “government support for NGOs,” “the formulation of standard strategic planning and goals,” “the establishment of a database and a network of NGOs,” and “the establishment of independent organizational units as the connectors and coordinators of NGOs' affairs in the public sector” are the critical facilitators for the improvement of NGOs' roles in Iran's health system.

CONCLUSION:
According to the findings of this study, only limited measures and efforts have been made to improve NGOs' roles and participation in the Iranian health system; at the same time, NGOs' participation in the health sector is far from ideal. Iranian health NGOs are at the beginning of this route, and they would inevitably require various legislative and structural mechanisms to succeed.
The effectiveness of digital storytelling in teaching medical information searching
Authors: Nouri Mohsen , Shahmoradi Leila , Mohammadi Aeen , Soleimani Hojat O. , Mojtahedzadeh Rita 
Published: May 2024

BACKGROUND:Novel technologies development has created a new path for education. Digital storytelling (DST) is one of the educational approaches used in universities and scientific centers. We aimed to investigate the effect of DST on Scientific Information Search (SIS) and Information Seeking Anxiety (ISA) in students.MATERIALS AND METHODS:This mixed-method study utilized the pre-test-post-test method containing test and control groups. We used the simple random sampling method (available) and used the formula to determine the sample size. Forty-two people participated in the study. A researcher-made questionnaire was used to collect SIS data and standard questionnaire for ISA data. The teaching approaches were accomplished using DST and the conventional methods in test and control groups, respectively. Using SPSS v. 22, we did paired-sample T-test and independent sample T-test to compare the mean score in before and after intervention in each group. Also Analysis of Covariancetest was used for considering post-test result as dependent variable, groups as independent variables and pre-test score as covariate.RESULTS:The results showed significant changes in mean score between the post-test and pre-test of both questionnaire in both groups. Also, in the post-test, compared to the control group, the experimental group obtained higher scores forSIS, which was statistically significant, and obtained lower scores forISA, but it was not statistically significant.CONCLUSIONS:It can be concluded that the DST method has a positive impact on learning and reducingISAcompared to the conventional ones, and students' interest and participation in learning have increased using DST method.
Elucidating experiences of faculty members in applying effective teaching strategies in the online class during the COVID-9: A qualitative study
Authors: Rezaei Habibolah , Ramezani Ghobad , Koohestani Hamid Reza , Zazoly Atefeh Zabihi , Taghavinia Mansoureh , Shirazi Mohammad Khabaz , Ostovarfar Maral , Baghcheghi Nayereh , Keshavarzi Mohammad Hasan 
Published: May 2024

BACKGROUND:
Despite the restrictions on providing medical courses online in medical universities, all instructors were required to provide training on virtual platforms. This study aimed to explain faculty members' experiences applying effective strategies in online class teaching.

MATERIALS AND METHODS:
This study has been done with a qualitative approach and using the method of conventional content analysis. Participants included 14 faculty members working at the Shiraz University of Medical Sciences. Semistructured interviews were used to collect data. Faculty members who had experience in conducting online classes were purposefully selected. Graneheim and Lundman's (2004) approach was used to analyze interview data.

RESULTS:
Two main categories were obtained from the data analysis: interpersonal communication and supportive behavior. The category of interpersonal communications comprises the subcategories of emotional expression and flexibility. The category of supportive behavior includes the subcategories of educational design, learner encouragement, diversity in evaluation, collaborative learning, and prompt feedback.

CONCLUSION:
Our findings confirmed that an appropriate teaching strategy leads to better attention to class and deep learning in learners. The cause is that in online classes, the student's attention is more minor than in daily classes due to its virtual nature. Appropriate educational strategies will motivate learners, interest them, and improve teacher interaction. These strategies increase students' participation in educational activities.
Attitude and perceptions of the faculty toward use of LMS in a tertiary medical college: An interventional study
Authors: Palve Suchitra S. , Palve Sachin B. 
Published: May 2024

BACKGROUND:
E-learning has become a new technique of instructional strategy during the current instructional era where we are surrounded with the uncertainty of pandemic outbreak and unrest in the educational system.

AIM AND OBJECTIVES:
To analyze and modulate the attitude and perception of the faculty towards the use of the Learning Management System for teaching and learning.

MATERIALS AND METHODS:
This descriptive cross-sectional study was conducted among 112 faculty members of Symbiosis Medical College for Women Pune. An elaborated research tool was designed to measure the attitudes and perception of the faculty members toward the use of the learning management system in teaching. The research tool was administered before and after the LMS sensitization workshop to all the participants. Workshop was planned to sensitize faculty regarding MOODLE (E-learning platform)

RESULTS:
Statically, significant change in the mindset of the faculty members was found after sensitization workshop regarding incorporating LMS as an instructional method. Statistically, significant variations were found in the attitude toward using LMS based on gender variation, (0.021, F = 5341), experience (0.033, F = 0.189), and discipline (0.052, F = 0.233). Based on the themes derived from responses faculty felt that training and sensitization will help them to use LMS more effectively.

CONCLUSION:
Use of blended learning strategies are need of an hour, there are lot of problems which can be faced by the faculty members while incorporating use of LMS in their routine teaching process. Training sessions for implementing any e-learning platform should be done on priority basis to increase its use more effectively.
Rectal xanthomatous polyp within the context of a normal serum lipid Profile: A case report
Authors: Rahman Adam Tolulope , Asaolu Olutoyin Iretiola , Ezenkwa Uchenna Simon 
Published: May 2024

Abstract
A xanthoma is a localized mass-forming collection of lipid-bearing cells (foamy histiocytes). They are uncommon in the gastrointestinal tract and reports among Nigerians are rarer. We present here a case of a 50-year-old hypertensive man, who had screening colonoscopy on account of positive fecal immunochemical test during a general health checkup. His clinical history and examination findings were unremarkable. He had marginally elevated plasma glucose values, but normal lipid profile. Findings at colonoscopy were a rectal polyp and erythematous patches in the transverse colon. The histology revealed lamina propria collections of foamy histiocytes, negative for periodic acid Schiff.
Soghin clinical practice guidelines for hepatocellular carcinoma
Authors: Ndububa Dennis Amojuaji , Abdulkareem Fatimah Biade , Mustapha Shettima Kagu , Ekwunife Christopher N , Omuemu Casimir Erhunmwun 
Published: May 2024

Abstract
HCC accounts for over 90% of primary liver cancers and 7% of all cancers from all sites worldwide. In Nigeria, HCC develops at a younger age compared to the developed world and co-exists with liver cirrhosis in about 80% of cases. The prognosis is dismal because the majority of HCC patients present with advanced disease, when only symptomatic treatment could be given. These Clinical Practice Guidelines contains extensive review of relevant data and provide practitioners in this resource-limited setting with the necessary information that would help detect liver cancer at early stages, when there is a possibility of cure, as well as assist in selecting patients, whose survival may be significantly prolonged, for treatment.
Therapeutic effectiveness and adverse drug reactions of mirabegron versus solifenacin in the treatment of overactive bladder syndrome
Authors: Raj Megha O. , Jose Jinish , Paul Fredrick , Sreedharan Syam , Uthaman Nithya 
Published: May 2024

Abstract

Introduction:
Overactive bladder (OAB) syndrome is a chronic disease characterized by urinary urgency with or without urge incontinence, frequency, and nocturia and antimuscarinic drugs such as solifenacin have been the mainstay of treatment. Mirabegron a beta 3 adrenoreceptor agonist has recently gained importance in the management of OAB. The rationale of the study is that mirabegron improves the storage function without affecting voiding which increases the therapeutic effectiveness. The objective was to determine the therapeutic effectiveness of mirabegron versus solifenacin.

Methods:
A prospective observational study was conducted on 298 patients with OAB syndrome attending the urology outpatient department of government medical college after obtaining institutional review board clearance. Patients of both genders, belonging to the 18–65 years of age group, attending the urology outpatient department were selected for the study. Patients were evaluated using the OAB-validated 8-question awareness tool (OAB-V8 score) before and after receiving drugs by direct questionnaire method after receiving informed consent. Patients were prescribed either solifenacin 5 mg or mirabegron 25 mg once daily by the urologist. Follow-up was done after 4 and 12 weeks. Adverse drug reactions of the drugs were assessed using the Central Drug Standard Control Organization suspected adverse reaction (ADR) form, and ADRs were notified to the nearest ADR monitoring center.

Results:
The mirabegron group showed maximum improvement in the mean OAB-V8 score values from baseline at 4 weeks (12.82 ± 5.86, P < 0.001) and 12 weeks (5.74 ± 3.31, P < 0.001) when compared to solifenacin. OAB-V8 scores of the solifenacin group also showed significant improvement from the baseline at 4 weeks (15.30 ± 5.54, P < 0.001) and 12 weeks (8.05 ± 4.59, P < 0.001). Heart rate, systolic, and diastolic blood pressures did not show significant changes during the follow-up in both the study groups. Thirteen patients developed ADRs such as dry mouth (four patients) and constipation (nine patients) in the solifenacin group. No ADRs were noted in the mirabegron group.

Conclusion:
Mirabegron showed maximum improvement in the OAB-V8 scores in patients with OAB syndrome, although the solifenacin group also showed improvement. Adverse effects were less in the mirabegron group when compared to the solifenacin group.