bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexmedetomidine addition to local anesthetic mixture for peribulbar anesthesia in strabismus surgery
Authors: Gabr Ahmed F. , Badry Badry M. , Rabea Mohammed H. 
Published: May 2024

Aim
To evaluate the effect of the addition of dexmedetomidine to the local anesthetic mixture for peribulbar anesthesia in strabismus surgeries.

Methods
A randomized controlled study included 58 patients who were divided into two groups, group І: included 29 patients who received peribulbar block by a mixture of local anesthetics only, and group II: included 29 patients who received peribulbar block by a mixture of local anesthetics with dexmedetomidine. All cases underwent preoperative full ophthalmic examination. The onset and duration of sensory block, onset and duration of motor block, hemodynamic parameters, sedation level, and duration of analgesia were assessed.

Results
The onset of sensory and motor block was shortened (P =0.021 and <0.001, respectively) and their duration was prolonged (P <0.001) and the duration of postoperative analgesia was significantly longer in the dexmedetomidine group (P <0.001). Dexmedetomidine group achieved higher sedation scores and lower intra and early postoperative pain scores (P 0.001 and <0.001, respectively) with higher levels of patient and surgeon satisfaction.

Conclusion
The addition of dexmedetomidine with the local anesthetic mixture for peribulbar anesthesia in strabismus surgeries accelerates the onset of anesthesia and akinesia of the globe and prolongs their duration. It extends the time to the first analgesic request and enhances the satisfaction of both patients and surgeons.
Effects of intracameral dexamethasone injection versus topical steroids post phacoemulsification operation
Authors: Ghonim Alaa I. A. , Elgharieb Mervat E. , Gab-Alla Amr A.-F. , Moawad Ehab M. 
Published: May 2024

Introduction
Cataract surgery is one of the most commonly performed surgeries worldwide, with nearly 20 million cases annually. Ophthalmologists usually use a prophylactic perioperative regimen consisting of topical corticosteroids and nonsteroidal anti-inflammatory drugs to reduce the risk of inflammation. However, patient compliance and other problems concerning administration with elderly patients self-administering medication drops can vary widely and a wide proportion of them fail to comply with a long-term regimen.

Aim
Evaluation of intracameral dexamethasone injection efficacy and safety versus topical anti-inflammatory eyedrop regimens for postphacoemulsification inflammation for better postoperative management of cataract patients.

Methodology
A prospective randomized clinical trial. Participants were divided into two groups in group A, dexamethasone sodium-phosphate (0.4 mg/0.1 mL) was injected intracamerally at the end of phacoemulsification surgeries without topical steroids postoperatively. Group B: took the routine postoperative anti-inflammatory steroidal and nonsteroidal eye drop regimen.

Results
Included the corneal thickness that showed no discernible change between postoperative numbers in both groups. Nevertheless, there was a statistically significant increase in CCT postoperatively in both groups. The intraocular pressure decreased significantly after 1 month of phacoemulsification operation in both groups simultaneously. Postoperative cell density and hexagonality were significantly lower in both groups compared with preoperative values. There was also no significant difference between both groups regarding the anterior chamber cells’ index. Moreover, the Dexamethasone-injected group showed better compliance on the postoperative visits regarding their prescriptions taken after the operation compared with the Prednisone acetate eye drops group.

Conclusions
Better results regarding the severity of the endothelial damage with the use of a single intraoperative injection post phacoemulsification compared with the group who did not get injected but took postoperative prednisone acetate eye drops. The obligatory single intraoperative injection of dexamethasone has handled the poor compliance of some patients’ post phacoemulsification.
A Case Series of Imaging Nuances of Persistent Craniopharyngeal Canal – Connecting the Pharynx to Brain!
Authors: Bajpai Amit , Chidanandaswamy Naveen , Hosur Bharat , Kurimilla Akshay , Dixit Nikhil , Sahdev Ravinder 
Published: May 2024

Abstract
Persistent craniopharyngeal canal (PCPC) is a rare congenital anomaly arising from the incomplete closure of the craniopharyngeal canal during embryological development. Imaging plays a crucial role in identifying and understanding the anatomical characteristics and guiding appropriate management strategies. We present a series of four cases of PCPC with varied and unexpected clinical presentations along with details of imaging nuances and management implications, emphasizing the importance of radiodiagnosis in guiding appropriate management strategies. From incidental diagnosis in an asymptomatic adult to a symptomatic syndromic child, the PCPC has a wide clinico-radiological spectrum of presentation as well as management challenges.
Comparative Analysis of Costing Methods for Magnetic Resonance Imaging in a Tertiary Care Teaching Hospital: An Observational Study
Authors: Kalita Bhaskar J. , Sahran Deepti , Jithesh V. , Sisaudiya Kuldeep Singh , Patel Kushagra D. , Yadava R. K. 
Published: May 2024

Abstract

Background:
Health-care costs, often determined through outdated methods, fail to capture the true costs of care delivery. Traditional costing methods in the health-care sector have proven insufficient, leading to potential revenue losses and increased patient out-of-pocket expenses. Activity-based costing (ABC) and time-driven ABC (TDABC) offer alternative approaches to cost calculation, aiming for a more accurate reflection of resource consumption.

Methodology:
This descriptive observational study was conducted in the magnetic resonance imaging (MRI) center of a tertiary care teaching hospital, focusing on a single noncontrast MRI scan costing. Direct observations and record reviews, including standard operating procedures, policy letters, financial documents, and miscellaneous records, were employed.

Results:
Using traditional costing, the unit cost of an MRI scan was calculated at INR 1291.51. ABC yielded a unit cost of INR 3613.77, while TDABC resulted in a unit cost of INR 2764.39. A comparison between the three costing methods revealed potential revenue losses with traditional costing. In contrast, TDABC appeared to strike a balance between financial prudence and reduced patient out-of-pocket expenses.

Conclusion:
The study emphasizes the significance of understanding true costs in health-care delivery. The results advocate for the adoption of TDABC as a favorable compromise, enabling the hospital to retain revenue without burdening patients with additional costs. Notably, the study highlights the necessity for a granular understanding of true costs for successful transitions from volume to value in health care.
A Case Series of Coinfection of Coronavirus Disease 2019 Breakthrough and Dengue Fever: Coexistence of Multiple Infections
Authors: Nagarjuna Pundla , Vardhan Prem , Babu Bhagya , Singh Sumeet , Kapoor Suraj , Bhaskar Vijay , Bobdey Saurabh , Yadav Arun Kumar 
Published: May 2024

Abstract
Coronavirus disease 2019 (COVID-19) is a respiratory illness caused by SARS-CoV-2. Dengue is one of the most common tropical diseases in India caused by dengue virus (DENV). COVID-19 and tropical diseases such as dengue and leptospirosis have a similar spectrum of clinical manifestations; therefore, it becomes very difficult to diagnosis. The present study describes five cases of coinfection of COVID-19 and dengue. A case series of patients reported to the flu clinic with fever and myalgia were tested, and diagnosed with SARS-CoV-2 and DENV as well as epidemiological and entomological investigations were also done for the identification of the source of infection. Laboratory reports were obtained from hospital laboratory data. Data were analyzed using Microsoft Excel. All patients were younger adult age group and were found to be residents of the same locality. The most common symptom found was fever associated with myalgia. Every patient had a history of contact with laboratory-confirmed COVID-19 cases and was fully vaccinated. Thrombocytopenia was seen in two patients. However, only one patient found immunoglobulin M or immunoglobulin G positive for DENV after discharge. No systemic complications were observed throughout the course of illness in patients. We described a case series of five patients with COVID-19 breakthrough and cases of dengue. Clinicians should have a suspicion of multiple infections while managing the cases.
Evaluation of neonatal presurgical echocardiographic requests for noncardiac surgery at the University of Uyo Teaching Hospital, Nigeria
Authors: Bassey Kevin , Okpokowuruk Frances Sam , Akpan Itoro Anietimfon , Ebiekpi Ifunanya Ularinma 
Published: May 2024

Abstract

Context:
There is a well-established association of congenital heart disease (CHD) with surgically correctable malformations particularly those of the gastrointestinal tract, genitourinary and central nervous systems. These malformations are typically corrected during the newborn period. Clinically significant and severe CHDs may worsen surgical outcomes.

Aims:
This study aimed to determine the prevalence of CHD diagnosed by echocardiography in neonates having noncardiac surgery at the University of Uyo Teaching Hospital. The study also aimed to assess if echocardiographic findings correlated with the severity of clinical presentation.

Settings and Design:
This was a retrospective review of the clinical and echocardiographic records of neonates who underwent noncardiac surgery between October 2020 and March 2023 at the University of Uyo Teaching Hospital.

Subjects and Methods:
Echocardiographic studies were done on all participants on a GE Vivid
Iq® machine using standard views. M-mode and two-dimensional data were recorded.

Statistical Analysis:
Data were analyzed using the Statistical package for socials sciences (SPSS) version 25.

Results:
Thirty patients had presurgical echocardiography done in the period accounting for 41% of all neonatal echocardiography requests. Twenty percent of the patients had a CHD identified. Atrial Septal Defects were the commonest CHD identified in 50% of patients. The association between clinical symptoms, gender, surgical diagnosis and the presence of CHDs were not statistically significant.

Conclusions:
Neonatal surgical anomalies are commonly associated with CHDs. The nature of most of the CHDs however appears to be mild. A preoperative assessment by a pediatric cardiologist is recommended to avoid undue delays.
Commentary on the 2022 American Heart Association/American College of Cardiology/HFSA guideline for the management of heart failure: The relevance to Nigeria
Authors: Karaye Kamilu Musa , Ogah Okechukwu S. , Sa’idu Hadiza , Adeoye Abiodun Moshood , Adebayo Rasaaq A. , Ansa V. O. 
Published: May 2024

Abstract
The 2022 American Heart Association /American College of Cardiology /Heart Failure Society of America Guideline, for the Management of Heart Failure, aimed to provide an update and consolidate the earlier versions, into a new document. Areas of focus in the 2022 heart failure (HF) guidelines are the prevention of HF and the new treatment strategies in HF using contemporary approaches to care. Influenza vaccination, a key nonpharmacologic intervention tested in a large cohort of HF patients including Nigerians, could significantly reduce clinical outcomes. This commentary aimed to clarify the relevance of this international standard practice guideline on HF, to the practice in Nigeria, and highlight the existing peculiarities. It is hoped that this commentary would serve as a prelude to a future Nigerian guideline for the management of HF.
Supraventricular tachycardia and cardiac embolization following umbilical vein catheterization
Authors: Onubogu Uchenna C , Amaewhule OU , Nwosu G 
Published: May 2024

Abstract
Umbilical venous catheter is a routine procedure in the neonatal intensive care unit used in securing intravenous access for various purposes, but malpositioning of this catheter can lead to life-threatening complications. We report the case of a female infant of a mother with gestational diabetes who was admitted in the special care baby unit at 1 h of life for prematurity, hypoglycemia, and presumed neonatal sepsis. She developed supraventricular tachycardia (SVT) within 24 h of having an umbilical catheter inserted for intravenous access; she later developed multiple intracardiac emboli. She was treated with digoxin, frusemide, Aldactone, heparin, antibiotics, and dextrose with the resolution of the intracardiac emboli. This case highlights some of the uncommon but serious risks of umbilical catheterization, which could be SVT and the possibility of developing an intracardiac embolus. In resource-poor settings where ultrasound-guided umbilical catheterization is limited, cardiac arrhythmias should be recognized as a potential complication of umbilical catheterization, which requires early intervention and treatment.
Electrocardiographic and Echocardiographic changes in Non-Hemodialysis Chronic Kidney Disease Patients: A Cross-Sectional Study
Authors: Ansari Mohammed Shoeb Himayun Kabeer , Noorani Mohammed Sohail Salim , Shaikh Ambreen Fatema Abdul Hafiz 
Published: May 2024

Abstract
Chronic Kidney Disease (CKD) patients have a higher risk of cardiovascular manifestations such as coronary artery disease, heart failure, arrhythmias, and sudden cardiac death. Cardiovascular diseases are the main cause of death in patients with advanced CKD, rather than end-stage kidney disease itself. Essentially, CKD speeds up the ageing process in the cardiovascular system. Objectives: To determine the prevalence of cardiovascular abnormalities in non-hemodialysis CKD patients. Methods: A descriptive cross-sectional study, was conducted in the Department of Medicine, between October 2020 to September 2022. A total of 50 CKD patients were included. The patients were evaluated & enrolled in the study, based on history, general physical examination, systemic examination, Blood Urea, Serum Creatinine, Urine Routine, Electrocardiograph (ECG) and Echocardiography. Results: In the present study Electrocardiograph & echocardiography determined cardiovascular abnormalities in 68% of patients. Among these 50% of patients had Left Ventricular Hypertrophy (LVH) & Left Ventricular Diastolic Dysfunction (LVDD), 8% of patients had Arrhythmias and 6% patients had conduction abnormality, 2% patients had LVH and 2% patients had LVDD. Conclusion: LVH & LVDD are the most common morphological abnormalities observed in our study. We can diagnose Arrhythmias and conduction abnormality by electrocardiogram & echocardiography and refer them for appropriate interventions promptly.
Therapeutic effect of Topical Sirolimus on Facial Angiofibromas in Patients of Tuberous Sclerosis Complex
Authors: HN Leena , Raghavan Savitha B , HR Yogesh , Sowmyanarayan Sujatha , Vittalrao Amberkar Mohanbabu , Hosthota Abhineetha 
Published: May 2024

Abstract

Introduction: Tuberous sclerosis complex (TSC) is a rare autosomal dominant disorder. Facial angiofibromas are the most common cutaneous findings of TSC. Treatment modalities such as laser, surgery, and/or cryotherapy are employed. Topical therapy with Sirolimus, an mTOR inhibitor, showed beneficial effects. Objective: To study the effects of topical sirolimus (0.1%) on Facial Angiofibromas in patients of TSC. Methodology
: Four patients with facial angiofibromas were included. They applied Sirolimus preparation twice daily, for 3 months. The Facial Angiofibroma Severity Index (FASI) was recorded pre-intervention, at 3 months and after 6 months. Results: All the patients showed a reduction in the FASI score at the end of three months of therapy. In three patients, on discontinuing therapy, there was no change in the FASI score at the end of six months, i.e., FASI 3 and FASI 6 were the same. Conclusion: Topical sirolimus is an effective treatment for facial angiofibroma in patients with TSC.
Step Up Approach in The Management of Pediatric Allergic Rhinitis
Authors: Irawati Nina , Awal Muhammad Irfan Ata Ul 
Published: May 2024

Allergic rhinitis (AR) is clinically characterized by two or more symptoms including itching, sneezing, nasal obstruction and rhinorrhoea. It is known to be caused by IgE-mediated hypersensitivity reaction in response to inhaled allergens. It has been shown to have high burden of disease, as patients with AR show significant reductions in the number of healthy days, interruption of daily activities due to symptoms, and overall reduction in quality of life. The International Study of Asthma and Allergies in Childhood (ISAAC) estimates the prevalence of AR across children and adults to be about 10-30% in the United States (US) and other developed countries. Allergic rhinitis negatively impacts quality of life directly through, or from the consequences of, its symptoms such as sleep disturbances, fatigue, impaired learning and cognitive functions, leading to reduction in productivity, worsened school performances and may also lead to embarrassment.
Utilization of Pre-Exposure Prophylaxis (Prep) Among HIV Discordant Couples in Four Mongu Urban Health Facilities - Zambia
Authors: Phiri Annie Kachepa , Mukwato P. K. , Kalusopa V. 
Published: May 2024

Purpose: The study was conducted to establish the rate of utilization of PrEP among discordant couples and factors associated with utilization. Findings from the study will assist policy makers to understand what measures to put in place in order to improve the utilization rate of PrEP among discordant couples in the district.
Methodology: A cross section analytical study design was used. A sample of 68 respondents were interviewed using a semi-structured questionnaire. The four health facilities were purposively selected while convenience sampling was utilized to select respondents. SPSS software version 16 was used for analysis. Descriptive statistics was used to calculate frequencies and percentages presented in tables and figures. To compute associations between the dependent and independent variables, Spearman's Correlation Coefficient, Chi-Square Test and Fisher’s exact test were used. All these were gauged at 95% confidence intervals (CI) with the p= value of 0.05.
Findings: Results of the study showed that the majority respondents (66%) n=45 were utilizing the service while (34%) n=23 were not. Spearman’s correlation test result showed that it was only occupation which was positive and statistically significant at (rs =.284, p=.019). The study has established that the casual workers, self-employed and those not working are more unlikely to use PrEP. However, knowledge level was at (rs=566, p=.071), waiting time was (rs=.021, p=0.565) clients waited for >30 minutes. Education level attained was positive but not significant (rs.071, p=.654). The higher the knowledge level and higher education attained are more likely to use PrEP
Unique Contribution to Theory, Policy and Practice: The study is also importance as it will add value to the body of existing literature on the utilization of PrEP among discordant couples. Policy makers in Western province and Mongu district will be able to make sound policies on HIV prevention by using the findings from this study.
Response Shifts in the Canadian Occupational Performance Measure: A Convergent Mixed-Methods Study
Authors: Ohno Kanta , Oi Riho , Harada Ai , Tomori Kounosuke , Sawada Tatsunori 
Published: May 2024

Abstract
Importance: A response shift (RS) is a phenomenon in which there is an individual perceptual gap between pre and post assessments. RS effects were not considered in the Canadian Occupational Performance Measure (COPM) development process.
Objective: To detect the effects of RS on the COPM.
Design: Convergent mixed-methods research.
Setting: Subacute rehabilitation hospital in Japan.
Participants: Nineteen adult patients with a range of neurological and musculoskeletal conditions recruited from a subacute rehabilitation hospital.
Outcomes and Measures: In the qualitative analysis, patients’ perceptions regarding occupation identified by the COPM were compared between the initial assessment (Time 1 [T1]) and a reassessment (Time 2 [T2]). In the quantitative study, patients were asked to re-rate the occupations in which the RS had occurred, giving feedback on their perceptions at T1 (T2′). The difference between T2 and T2′ was calculated to clarify the magnitude of the RS.
Results: Of the 19 patients, 18 had an RS in at least one occupation. The RS effects were classified into five categories: Replacing, Adding, Reducing, Unspecified, and Embodiment. Ninety occupations were extracted from all the patients, and 46 (51.1%) were affected by RS. The percentages of occupations for which the change in score due to RS exceeded the minimal clinically important difference (±2 points) was 26.1% (12 of 46) for COPM–Performance scores and 30.4% (14 of 46) for COPM–Satisfaction scores.
Conclusions and Relevance: Diverse RS effects have been identified in the COPM, which also affect score interpretation.
Plain-Language Summary: The Canadian Occupational Performance Measure has a potential measurement bias that is due to a response shift in which there is an individual perceptual gap between pre and post assessments. The results of this study reveal a need to establish more accurate measurement methods to reduce the impact of response shifts on COPM scores.
A CROSS-SECTIONAL STUDY ON MALIGNANT TERTIAN MALARIA AMONG CHILDREN BELOW FIVE YEARS ATTENDING THE OUTPATIENT DEPARTMENT LABORATORY AT JINJA REGIONAL REFERRAL HOSPITAL.
Authors: NABUNJE HAJJARAH , TURYATUNGA BEN 
Published: May 2024

Background:
World Health Organisation estimates that 229 million new cases of Malignant Tertian Malaria in 2019 in the world. 3.3 billion people in tropical regions and Uganda there is still a high mortality rate, especially in children below five years.
Purpose of the study: The study was to determine the prevalence of Malignant Tertian Malaria among children below five years at Jinja Regional Referral Hospital.
Methodology:
A descriptive cross-sectional study was used and data was obtained from 146 respondents using an interviewer-administered questionnaire diagnosed, described, analyzed, and presented information on tables and figures using Microsoft Excel.
Results:
The prevalence of MTM was 48.6% among children below five years. The most common socio-economic factor was household structure with a prevalence of 56.33% and 43.66% for respondents who were staying in completed houses and those whose houses were not in good condition respectively. The knowledge of caretakers about MTM was inadequate most caretakers knew about MTM with a prevalence of 63.38%.
Conclusion:
Although interventions for the management of MTM were in place, a prevalence of 48.6% was still high and demands for additional efforts from the health workers and the Ministry of Health to lower the heavy disease burden.
Recommendation:
The health workers should offer health education about MTM to the patients attending the hospital and emphasis on early diagnosis and treatment of MTM infections should be prioritized.
SILVA, Márcio Rosa da. 2022. Sistema de justiça indígena: aspectos jurídicos e antropológicos.
Authors: Cirino Carlos Alberto 
Published: May 2024

A resenha da obra
Márcio Rosa da Silva 2022. Sistema de justiça indígena: aspectos jurídicos e antropológicos.que, por sua vez, aborda o sistema jurídico do indígenas Ingarikó de Roraima.