bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gender Differences in the Timing of Identification among Children with Autism
Authors: Malhi Prahbhjot , Singhi Pratibha 
Published: May 2024

Background and Objectives:
There is a paucity of research studies, especially from the low- and middle-income countries, on gender-specific clinical profiles of autism and whether this lack of information is a barrier for early diagnosis among females. The present paper examined the gender differences in the timing of identification of autism among children.

Methods:
The case records diagnosed children with autism spectrum disorder with no documented intellectual disability (IQ <70) were retrospectively analyzed. The demographic and clinical characteristics such as the presence of repetitive behaviors, deficits/delays in language, social-emotional reciprocity impairments, history of developmental regression, presence of hyperactivity, and self-injurious behaviors were extracted from the case files. Gender differences in the timing of identification, clinical characteristics, and sociodemographic variables were examined by utilizing the t-test.

Results:
A total of 309 case records (Mean = 5.04 years, standard deviation = 2.50) were retrieved. Girls, as compared to boys, were significantly less likely to show restricted and repetitive behaviors (χ² = 3.92, P = 0.048) and showed greater socio-emotional reciprocity despite a similar level of autism severity (χ² = 4.48, P = 0.034). No sex differences were found in hyperactivity, self-injurious behavior, history of developmental regression, and severity of autism (all P > 0.05). There was a significant difference in the timing of the identification of autism by gender and females were found to be identified at significantly older ages relative to males (t = 2.13, P = 0.034).

Conclusions:
There is an imperative need to develop more gender-sensitive diagnostic tools incorporating the sex-specific differences in clinical presentation to improve the assessment of autism in girls.
Perception of 2nd-Year Medical Undergraduates Regarding the Implementation of Competency-Based Medical Education in Pharmacology
Authors: Mahalmani Vidya M. , Hashilkar Nayana K. , Hogade Anil P , Basavaraj Netravathi Angadi 
Published: May 2024

Objectives:
The purpose of the study was to understand the perception of 2nd-year medical undergraduates regarding the implementation of competency-based medical education (CBME) in pharmacology.

Materials and Methods:
This cross-sectional study was undertaken by the department of pharmacology, in our institution. Out of 197 s year medical undergraduate students, 192 provided their valuable feedback. The questionnaire consisted of three types of questions: (1) multiple-choice questions, (2) rating on a 5-point Likert scale, and (3) open-ended questions. In the open-ended questions, the students were asked to share their views. Responses to the questions were recorded. Students’ “feedback responses” were scrutinized in terms of percentages. Conceptual content analysis was done for open-ended questions.

Results:
Students were satisfied with the implementation of CBME as well as the conduct of small group teaching, self-directed learning, integrated assessment, attitude, ethics, and communication skills, and pandemic modules. They emphasized more on game-based learning and other innovative teaching–learning methods that drove their interest to understand the subject better.

Conclusion:
Implementation of CBME has been found to be more effective than the traditional didactic approach.
Complex Ovarian Cysts in Infants: A Series of Nine Cases
Authors: Chakraborty Partha , Halder Pankaj Kumar , Mandal Ananya , Yadav Sunil Kumar , Ghosh Sarannya , Saha Anusua 
Published: May 2024

Abstract
Female infants frequently develop ovarian cysts (OCs), which vary in onset, development, and prognosis. When the placenta tissue secretes excessive human chorionic gonadotrophin for a variety of reasons, the fetus develops an OC. Because estrogen levels fall after childbirth, the majority of OCs may also naturally involute. Hence, treating infants with OCs may involve close observation. However, even in previously asymptomatic OCs, torsion, intracystic bleeding, or ovarian necrosis could manifest suddenly in the neonatal or infantile period. Here, we report nine such cases of OCs and share our experiences with diagnosis and treatment.
Comparison of the Effect of Conventional Nasal Packing and Merocel Packing following Deviated Septal Surgeries
Authors: John Ferrin Maria , Valli R. , Kiren T. 
Published: May 2024

Abstract

Context:
Nasal packs are necessary after nasal surgery for hemostasis and internal stabilization of bony and cartilaginous structures.

Aims:
The study was done to compare the outcomes of conventional nasal packing and Merocel packing in terms of the middle ear pressure, mucociliary clearance, patient comfort, and complication.

Settings and Design:
A prospective study was conducted among 40 patients in a tertiary care center for 18 months.

Subjects and Methods:
The patients between 18 and 50 years and who underwent septal surgery were included in the study. The patients with any history of ciliary dysfunction, who underwent functional endoscopic sinus surgery with septoplasty, and any middle ear diseases were excluded from the study. The patients were divided into Group 1, which had conventional nasal pack and Group 2, which had Merocel postoperatively. All the patients were assessed with impedance audiometry and sacchrin test preoperatively and postoperatively at 1, 2 and 4 weeks and these were compared between the 2 groups. During pack removal, pain and bleeding and postoperative complications were also compared between the groups.

Statistical Analysis Used:
The difference between the two-group comparison student t-tests, the differences between the right and left sides of the same tests paired t-test. The association/difference between categorical variables Chi-square test was calculated at a 5% level of significance.

Results:
Group 1 and Group 2 had a mean age of 38.47 and 37.47, respectively. Gender predisposition in Group 2 is 1:1 and in Group 1 is 3:2. The middle ear pressure returns to normal by 2nd week in Group 2 compared to Group 1, which improved by 4th week (P < 0.05). The mucociliary clearance reverts to normal by 1st week in Group 2 and 4th week in Group 1 (P = 0.0001) was statistically significant. Group 2 had lesser pain scores assessed using visual analog scores (P = 0.0001) and less bleeding (P = 0.01), which was statistically significant. Group 2 has fewer postoperative complications.

Conclusions:
The conventional and Merocel packs were both effective packs. In terms of mucociliary clearance, the middle ear pressure Merocel packing was better, and conventional nasal packing had more incidence in terms of postoperative complications.
Exploring the Role of YouTube in Supplementing Medical Education and Patient Care
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh 
Published: May 2024

Abstract
Significant paradigm shifts and reforms have been reported in the field of medical education delivery worldwide depending on the changing health-care needs of the community and the demands of medical students. The purpose of the current review is to explore the role of YouTube in facilitating the delivery of medical education and improving clinical practice on the global platform. An extensive search of all materials related to the topic was carried out on the PubMed and Google Scholar search engines and a total of 49 articles were selected based on their suitability with the current review objectives and analyzed. Keywords used in the search include YouTube, social media, and medical education in the title alone only. Being a freely available platform that can be accessed by anyone, YouTube has emerged as a platform that can be looked upon as an option to combine different kinds of educational resources for the benefit of medical students. In addition, the introduction of YouTube as a learning resource material has played a significant role in improving confidence levels, better acquisition of knowledge, and improved levels of satisfaction among students. To conclude, social networking sites like YouTube have emerged as one of the popular tools of information and educational material for the benefit of medical students and health-care professionals. Realizing the potential of the platform, it is high time that specific steps are taken to integrate YouTube into the medical curriculum and help students and health-care professionals to acquire knowledge and clinical skills.
Methylene Blue-mediated Photodynamic Therapy for the Treatment of Oral Leukoplakia
Authors: Bhandari Akanksha , Budakoti Akansha , Chaudhary Manjari 
Published: May 2024

Abstract

Objective:
To evaluate the efficacy of methylene blue-mediated photodynamic therapy (MB-PDT) for the treatment of oral leukoplakia (OL) and compare it to systemic Vitamin A therapy.

Materials and Methods:
Forty clinically and histopathologically confirmed cases of OL were included. They were divided into two groups: 20 were given systemic Vitamin A therapy and on the other group MB-PDT for 30 days. Pre- and posttreatment assessment of size of lesion and clinical appearance were done and followed up for 1 year to check for recurrence and delayed side effects.

Results:
The reduction in size of lesion pre- and posttreatment was statistically nonsignificant in the Vitamin A Group, but statistically highly significant in the PDT group according to unpaired t-test with no immediate or delayed side effects seen in both the groups.

Conclusion:
Both the treatment methods showed response in terms of reduction of size of lesion, but MB-PDT was a better treatment option for OL.

Clinical Relevance:
Oral cancer is often preceded by various premalignancies, OL being the most common among them. Early diagnosis and intervention will prevent malignant transformation thereby reducing the cost, side effect and mortality associated with oral cancer. Considering the prevalence, symptomless nature of OL, an effective, well-accepted mode of treatment with minimal side effects is of utmost need.
Outcome of Treatment for Hepatitis C Infection in Hemodialysis Patients with Direct-Acting Second-Generation anti-HCV Drugs at Azzawiyah Kidney Hospital, Libya
Authors: Shaibani Badreddin , Ayad Khairi , Melodi Marwa , Albarasi Sabah , Annajar Badereddin , Jibani Mahdi 
Published: May 2024

Background:
Hepatitis C virus infection is the most common viral infection in patients on hemodialysis and is a leading cause of chronic liver disease in end-stage renal disease patients. The main aim of this study was to review the outcome of the treatment of HCV in hemodialysis patients with second-generation anti-HCV drugs at Azzawiyah Kidney Hospital.

Patients and Methods:
Thirty-two hemodialysis patients with proven HCV infection (HCV-polymerase chain reaction-positive) received antiviral treatment for 12 weeks and followed up for 12 months, with liver function tests and repeated HCV-RNA. The primary outcome was the proportion of patients who achieved sustained virological response at 12 weeks posttreatment (SVR-12).

Results:
32 patients (32/280, 11.4%) out of the total number of (280) regular hemodialysis patients were proven to have HCV infection, during the period from December 2016 to December 2019. The median age of the study population was 53.5 ± 12 years, and 55% were females. The median duration of dialysis was 9.6 years (range 3–25 years). The causes of chronic kidney disease were diabetes mellitus at 43.7%, hypertension at 25.5%, adult polycystic kidney disease at 12.5%, and chronic glomerulonephritis at 9.3%. Twenty nine (29/32) patients received antiviral treatment with sofosbuvir/daclatasvir (SOF/DLC) and (3/32) patients with elbasvir and grazoprevir (ERB/GZR). 96.9% of SOF/DLC achieved SVR 12 and 100% of EBR/GSR by the end of the treatment, only one patient (3.1 %) failed to achieve it. No significant side effects were reported for the treatment drugs.

Conclusion:
This study confirmed that the treatment of hemodialysis patients with chronic hepatitis C infection with second-generation anti-HCV drugs is safe and has elicited a sustained negative virological response.
Bromfenac 0.09% for the Treatment of Macular Edema Secondary to Noninfectious Uveitis
Authors: Saade Joanna S. , Istambouli Rachid , AbdulAal Marwan , Antonios Rafic , Hamam Rola N. 
Published: May 2024

PURPOSE:
The topical nonsteroidal anti-inflammatory drug bromfenac 0.09% has a potential benefit in uveitic macular edema (UME) with a safe side effect profile. The aim of the study is to assess the efficacy of bromfenac sodium solution in the treatment of UME.

METHODS:
The charts of 10 patients with macular edema due to noninfectious uveitis treated with bromfenac 0.09% were reviewed retrospectively. The main outcomes studied were the best-corrected visual acuity (BCVA) and the central retinal thickness (CRT) compared 4 months before bromfenac initiation, at the time of its initiation, and 4 months later.

RESULTS:
Twelve eyes of 10 patients were included. BCVA and CRT were unchanged 4 months befoew bromfenac compared to the time of bromfenac initiation (P = 1.0 and P = 0.2, respectively). There were a significant improvement in BCVA after 4 months of bromfenac treatment (P = 0.043) and a significant decrease in CRT (P = 0.002). Subretinal fluid resolved completely in 8/9 eyes, and 4/9 eyes had a complete resolution of cystoid macular edema at 4 months.

CONCLUSION:
Bromfenac may be a useful addition to the treatment of UME.
Validation of Artificial Intelligence Algorithm in the Detection and Staging of Diabetic Retinopathy through Fundus Photography
Authors: Pawar Bhargavi , Lobo Suneetha N. , Joseph Mary , Jegannathan Sangeetha , Jayraj Hariprasad 
Published: May 2024

PURPOSE:
Diabetic retinopathy (DR) is one of the leading causes of vision loss globally, and early detection plays a significant role in the prognosis. Several studies have been done on the single field fundus photography and artificial intelligence (AI) in DR screening using standardized data sets in urban outpatient settings. This study was carried out to validate AI algorithm in the detection of DR severity using fundus photography in real-time rural setting.

METHODS:
This cross-sectional study was carried out among 138 patients who underwent routine ophthalmic examination, irrespective of their diabetic status. The participants were subjected to a single field color fundus photography using nonmydriatic fundus camera. The images acquired were processed by AI algorithm for image quality, presence and refer ability of DR. The results were graded by four ophthalmologists. Interobserver variability between the four observers was also calculated.

RESULTS:
Of the 138 patients, 26 patients (18.84%) had some stage of DR, represented by 47 images (17.03%) positive for signs of DR. All 26 patients were immoderate or severe stage. About 6.5% of the images were considered as not gradable due to poor optical quality. The average agreement between pairs of the four graders was 95.16% for referable DR (RDR). The AI showed 100% sensitivity in detecting DR while the specificity for RDR was 91.47%.

CONCLUSION:
AI has shown excellent sensitivity and specificity in RDR detection, at par with the performance of individual ophthalmologists and is an invaluable tool for DR screening.
Multi-purpose Disinfecting Solutions only Partially Inhibit the Development of Ocular Microbes Biofilms in Contact Lens Storage Cases
Authors: de Araújo Fabiano B.M. , Morais Vinicius C. , de Oliveira Bianca T.M. , de Lima Kaíque Y.G. , Gomes Victor T. , do Amaral Ian P.G. , Vasconcelos Ulrich 
Published: May 2024

PURPOSE:
Certain ocular resident or pathogenic microbes may remain viable in the presence of multi-purpose disinfectant solutions (MPDSs), subsequently developing biofilms inside contact lens storage cases (CLSCs) which pose a risk of infection to wearers. This study evaluated the formation of ocular microbiota biofilms exposed to three top selling MPDS.

METHODS:
Crystal violet assay was carried out for the verification of biofilm formation. The in vitro assays evaluated Pseudomonas aeruginosa UFPEDA 416 and Staphylococcus aureus UFPEDA 02 exposure of 48 h to MPDS, as well as the use of 40 KHz ultrasound at the beginning and with 24 h immersion in the MPDS. Subsequently, in vivo assays evaluated the formation of microbial biofilms on the CLSC walls containing silicone-hydrogel contact lenses immersed in MPDS from 15 healthy volunteer patients, who had been wearing the lenses for 7 days.

RESULTS:
Biofilms were inhibited by 26%–98% in the in vitro assays, with a statistically significant difference only for P. aeruginosa UFPEDA 416 exposed to diluted MPDS. Most inhibitions occurred moderately and weakly. In addition, adherent cells were detected in more than 90% of the tests. Biofilm was not inhibited in more than one third of the results, nor was it disturbed, especially with the ultrasound treatments. The average of obtained optical densities at 590 nm was between 0.6 and 0.8 in the in vivo assays. The results were similar between the CLSC right and left wells. There was a correlation between microbial biofilm formation and the type of MPDS tested, with statistical difference between the three treatments.

CONCLUSION:
MPDS promoted a partial inhibition of microbial biofilm formation but only one MPDS proved to be more effective in vitro and in vivo. This study, however, could not distinguish the effect of possible errors in the good hygiene practices of the users.
A Prospective Evaluation of the Effect of Mitomycin-C on Corneal Endothelium after Photorefractive Keratectomy for Myopia Correction
Authors: Mohan Sashwanthi , Gogri Pratik , Murthy Somasheila I. , Chaurasia Sunita , Mohamed Ashik , Dongre Pankaj 
Published: May 2024

PURPOSE:
The aim of the study was to assess the effect of mitomycin-C (MMC) 0.02% application on corneal endothelium in patients undergoing photorefractive keratectomy (PRK) for the correction of myopia and compound myopic astigmatism.

METHODS:
A prospective observational study including patients with myopia who underwent PRK plus intraoperative application of MMC 0.02%. All patients underwent noncontact specular microscopy preoperatively and 6 months postoperatively. The following parameters were analyzed: mean cell area (MCA), central corneal endothelial cell density (ECD), and coefficient of variation (CV) in cell size.

RESULTS:
One hundred and thirty-nine eyes of 73 patients with a mean age of 24.95 ± 3.23 years were included in the study. Mean baseline preoperative pachymetry was 519.54 ± 28.62 μm. The mean preoperative spherical equivalent was −4.6 ± 2.3D (range from −1D to −10D) which decreased to mean postoperative spherical equivalent of −0.125 ± 0.32D. Mean baseline ECD was 2829.3 ± 188.8 cells/mm2, MCA was 354.6 ± 24.9 μm2/cell, CV was 0.35 ± 0.06, and hexagonality was 50.1 ± 6.64. The mean ECD decreased by 43 ± 1.6 cells/mm2 which was not statistically significant (P = 0.07). The MCA increased by 5 ± 1.3 μm2/cell, but this was not statistically significant (P = 0.07). However, both the CV and percentage of hexagonal cells showed statistically significant differences in the median values as compared to preoperatively (P < 0.001).

CONCLUSION:
In our study, MMC had no significant effect on corneal endothelial cell counts or MCA. While there were statistically reduced CV and percentage of hexagonal cells, these did not appear to be clinically significant. MMC is safe to use routinely to prevent haze formation in PRK.
Burden and Presentation of Age-Related Macular Degeneration among Nigerians
Authors: Okonkwo Ogugua N. , Ibanga Affiong , Adenuga Olukorede , Nkanga Dennis , Ovienra Wilson , Agweye Chineze T. , Akanbi Toyin , Oyekunle Idris , Udoh Martha-Mary 
Published: May 2024

PURPOSE:
Age-related macular degeneration (AMD) is a leading cause of visual impairment worldwide, and its prevalence may also be on the increase in Nigeria. The purpose of this study is to ascertain the burden and pattern of presentation of AMD in a developing country.

METHODS:
We conducted a multicenter, prospective study from January to December 2018. Biodata and history of systemic disease were obtained from consecutive patients presenting at four collaborating retina clinics and diagnosed with a retina disease after dilated fundus examination and ocular investigations such as fundus photography, fluorescein angiography, and optical coherence tomography. All eyes diagnosed to have wet and dry AMD were used for the study analysis.

RESULTS:
Out of 8614 patients, 156 eyes of 78 patients were diagnosed with AMD. The hospital-based prevalence for AMD was 0.91%. The mean age at presentation was 67.9 ± 9.2 years, ranging from 44 to 95 years. A majority (75.6%) of patients were between 60 and 79 years, 53.8% were females. Thirty-two eyes (20.5%) had wet AMD, while 124 eyes (79.5%) had dry AMD. Sixty-one eyes (39.1%) had moderate visual impairment (<6/18-6/60); 58 eyes (37.2%) had normal vision (6/18 and better); while 27 eyes (17.3%) were blind, and ten eyes (6.4%) had severe visual impairment.

CONCLUSION:
AMD contributes to the burden of visual impairment and blindness in the elderly Nigerian. In Nigeria, AMD occurs more in females and most common between the ages of 60 and 79. Dry AMD is four times more common than wet AMD. About 24% of eyes have severe visual impairment or blindness, while about a third each have a moderate visual impairment and normal vision. Increasing awareness of AMD among the at-risk population will be beneficial in achieving early diagnosis and treatment.
An Algorithm for the Reconstruction of Nonfingertip Upper Extremity Soft Tissue Defects
Authors: Bas Soysal , Sizmaz Mert , Aydin Alican , Sirvan Selami Serhat , Karsidag Semra 
Published: May 2024

Aims:
The aim of this study was to evaluate the advantages and disadvantages of reconstructive methods used in the upper extremity soft tissue defects other than the fingertips, according to location.

Materials and Methods:
This retrospective study included 212 patients operated between January 2012 and January 2019 due to upper extremity soft tissue defects excluding the fingertip. Patients were evaluated in terms of age, gender, etiology, reconstruction area, method, and complications.

Statistical Analysis Used:
The relationship between the reconstructive method or location and the complication was evaluated by one-way analysis of variance test. The relationship between categorical variables was tested by Kruskal–Wallis test. The significance of multiple comparisons was adjusted using Bonferroni correction.

Results:
The average age of patients was 35.4 ± 19.12 years; 168 were male and 44 were female. 158 patients were operated for trauma, 34 for malignant tumor, 12 for infection, and 8 for extravasation. Complications were observed in 19 of the 220 reconstructive procedures (8.6%): two of the local flaps, three distant flaps, two regional flaps, five perforator flaps, and seven free flaps. 26% of these complications were seen in fingers, 15% in hands, 42% in wrists, 5.2% in forearms, 5.2% in elbows, and 5.5% in arms.

Conclusions:
There are many procedures for upper extremity reconstruction that can be selected according to defect location and character. It should be kept in mind that complex reconstructions that are preferred especially in complicated injuries may end up with challenging complications. In these types of complicated injuries, it would be better to prefer a reconstructive ladder instead of a reconstructive elevator.