bluuebunny/crossref_metadata_2025_split huggingface dataset:
Covert, Grandiose, and Dysfunctional Subtype of Narcissistic Personality Disorder
Authors: Annigeri Bindu , Raman Rajesh , Manohar Shivananda , Sardesai Sopan 
Published: March 2024

Abstract
Narcissistic personality disorder(NPD) is described in the DSM-IV-TR as “a pervasive pattern of grandiosity, need for admiration and lack of empathy.” The other features are: grandiose sense of self-importance and grandiose fantasies, belief in being special and unique, need for admiring attention, sense of entitlement, exploitation, arrogance, lack of empathy, and envy of others or belief that others envy them. Other features are: vulnerable self-esteem; feelings of shame, sensitivity and intense reactions of humiliation, emptiness or disdain to criticism or defeat; and vocational irregularities resulting from difficulties tolerating criticism or competition. Hence, NPD should be understood from the context of grandiosity and self esteem dysregulation. The subtypes of NPD i.e. the shy, covert, besides the arrogant, overt, grandiose and unempathetic helps emphasise the phenomenologic range of narcissism. We report a case of narcissistic personality disorder, who presented with the unusual subtype with shyness, covertness, poor functioning, but grandiose.
Atypical Antipsychotics and Sexual Functions in Schizophrenia: A Cross-sectional Study
Authors: Singh Charanpreet , Sharma Rachit , Rakesh C. 
Published: March 2024

Abstract

Background:
Antipsychotics are associated with sexual dysfunction. However, studies selectively exploring the sexual impact of atypical antipsychotics in a standardized male population are limited, and further more in the Indian context. Thus, a need was felt to understand, explore and assess the impact of atypical antipsychotics on sexual wellness in a standardized male population suffering from Schizophrenia.

Objective:
To study the effect of Atypical Antipsychotics on Sexual functions in sexually active male patients of Schizophrenia treated with Atypical Antipsychotics.

Materials and Methods:
150 sexually active freshly diagnosed treatment naïve males with Schizophrenia were administered atypical antipsychotics. Their sexual functions were assessed after 1 month using Arizona Sexual Experience Questionnaire (ASEX).

Results:
Olanzapine, risperidone, and clozapine had maximum incidence of sexual dysfunction (SD) while quetiapine and aripiprazole were having the least. 54% had one or more SD, prominent ones being low sexual desire (54%), dissatisfaction with their sexual drive (41.3%), dissatisfaction with orgasm (39.3%) and inability to reach orgasm (32%).

Conclusion:
SD rates are higher among patients of Schizophrenia treated with Atypical Antipsychotics. All the domains of sexual functioning are affected. Clinicians should routinely assess the sexual functioning in patients on treatment with antipsychotics and should incorporate sexual health as a dimension in their treatment plan.
Primary Gastrointestinal Lymphoma: Clinicopathological Study: 10 Years Experience in a Tertiary Care Center in Southern India
Authors: Bhayani Priyansh Deven , Rao Amara Sadguna , Shah Aditya , Natarajan Kartik , Shah Saloni Naresh , Piramanayagam Paramasivan 
Published: March 2024

Background:
The gastrointestinal tract (GIT) is a common site for extranodal lymphomas, accounting for 10%–15% of all non-Hodgkin lymphoma cases and 30%–40% of extranodal lymphomas. Regarding the incidence of the various histological subtypes and areas of involvement, there is a lot of heterogeneity in the literature. This study looked into the anatomical distribution, histological subtypes, and locations of primary gastrointestinal tract lymphomas (PGL) that were seen at a tertiary referral hospital in Southern India.

Materials and Methods:
A retrospective analysis of 96 individuals who had been diagnosed with PGL over the course of 10 years (2012–2022) was done. We carried out an audit of the clinicopathological profile of patients with PGL diagnosed over a period of 10 years. All lymphomas were classified according to the World Health Organization’s 2008 classification.

Results:
Of the 96 patients with PGL, 74 (77%) were male. The most common site for PGL was the stomach (50%), followed by the terminal ileum (14.58%). The most common histological subtype was diffuse large B cell lymphoma (DLBCL), which was seen in 85.42% of the patients. The most common symptom was abdominal pain (51.04%). Rituximab–cyclophosphamide–doxorubicin–vincristine–prednisolone was the most commonly used treatment regimen (56.3%).

Conclusion:
In this large single-center retrospective study, we found that the pattern of distribution of PGLs in India is comparable to the Western literature in that the stomach is the most prevalent site of PGL and DLBCL is the most common histological subtype.
Psilocybin for the treatment of posttraumatic stress disorder: A magic to treat a harmony of illusions?
Authors: Khanna Rakesh 
Published: March 2024

Abstract
A review of the literature on posttraumatic stress disorder (PTSD) suggests it to be a complex disorder with many contributing factors. The concept of PTSD has continued to evolve over time. A diagnosis of PTSD may be hard to get right. Studies suggest a wide variation in its presentation and diagnostic stability. It is tempting to explore the possibility of using chemicals that could help shorten the process of reaching the unconscious mind that could lead to more rapid remission. This article aims to review limitations in seeing the effectiveness of psilocybin (magic mushroom)-assisted therapy for PTSD. Psilocybin is supposed to be just a catalyst for treatment, while psychotherapy is considered the mainstay of treatment. The therapy itself is to be nondirective, geared toward providing a sense of safety for the patient in a vulnerable state and allowing the person to direct the support while being in a chemically compromised state. We may repeatedly be falling into the trap of trying to find simple solutions to problems that are by their very nature quite complex. All interactions take place in a certain context, and their effect will depend on how they are taken up by the whole person/world system.
Comparison between using intrauterine misoprostol with oxytocin infusion and oxytocin alone in reduction of blood loss in cesarean delivery
Authors: Abd Almageed Ghada Abd Al R.A. , Al-Noor Iman I. , Halim Hala W.A. 
Published: March 2024

Background
Postpartum hemorrhage is an unexpected obstetricity and one of the five major causes of death among women in both developed and nondeveloped countries. Many women over 20 weeks of pregnancy are at risk of experiencing postpartum hemorrhage and its consequences.

Objective
To compare the effectiveness of the combination of intrauterine misoprostol and oxytocin infusion and oxytocin infusion alone in decreasing blood loss at cesarean delivery.

Patients and methods
The study participants were selected randomly, and a trial was carried out at Al-Zahraa University Hospital in the period between May 2019 to January 2020. A total of 200 pregnant women referred to the cesarean section (CS) were divided randomly into two study groups: group I received 800 μg of misoprostol intrauterine after delivery of placenta, which was inserted at cornual part bilaterally, 400 μg in each group combined with 20 U of oxytocin infusion after delivery of the fetus. Group II was given 20 U of oxytocin infusion after delivery of the fetus. Blood loss during CS was measured. Hemoglobin and hematocrit values were measured preoperatively and 24 h postoperatively.

Results
Intrauterine misoprostol mixed with oxytocin infusion led to a substantial decrease in the intraoperative blood loss in comparison with oxytocin alone (561.42±113.33 vs. 653.60±149.52 ml) (P=0.001). In addition to that, there was a reduction that was statistically significant in the median differences of hemoglobin [1.20 g/dl (0.70–1.5) vs. 1.7 g/dl (1.3–2.2)] (P=0.001) and hematocrit [1.40% (1.1–1.2) vs. 4.5% (3–6.1)] (P=0.001) values when measured before and 24 h after CS. The need for additional uterotonics was highly decreased in the study group (5%) compared with the control group (16%). There was no significant difference in the incidence of adverse effects of misoprostol between the two groups.

Conclusion
The use of 800 µg intrauterine misoprostol combined with oxytocin infusion in CS can significantly reduce blood loss, preserve hemoglobin and hematocrit, and decrease the need for additional uterotonics without significant adverse effects when compared with oxytocin infusion alone.
Role of MRI in evaluation of low back pain in adults
Authors: Elmelegy Rania E.M. , Elfeshawy Mohamed S. , Hasan Rawhia T. 
Published: March 2024

Objective
This study aimed to evaluate the causes of low back pain (LBP) by MRI among the adults.

Patients and methods
This was a prospective study carried out at Al-Zahraa University Hospital. Adequate clinical history was taken from patients complaining of LBP, and MRI was performed for these patients, from March 2020 to August 2020. The patients were categorized according to age, sex, characterization of pain, and finding of MRI.

Results
This study was performed on 100 patients ranging in age from 20 to 70 years and revealed that the majority of patients were obese females, representing 52 (52%) patients, and belonged to the age group of more than 45 years [61 (61%) patients]. In most cases, the pain is associated with sciatica [70 (70%) patients], and the most common cause of LBP was spondylodegenerative changes [80 (80%) patients].

Conclusion
LBP is a common health problem in our locality, and MRI is a good diagnostic tool for evaluation of causes of LBP.
Ligasure versus Milligan-Morgan hemorrhoidectomy
Authors: Abdelaziz Heba T. , El Halim Sherif Abd 
Published: March 2024

Background
Conventional hemorrhoidectomy for grades III and IV hemorrhoids is a tedious procedure associated with significant morbidity and a prolonged convalescence. We compared LigaSure hemorrhoidectomy with conventional (Milligan-Morgan) hemorrhoidectomy for the treatment of grades III and IV hemorrhoids.

Patients and methods
A total of 80 consecutive patients of grades III and IV hemorrhoids were randomized to either the LigaSure hemorrhoidectomy (40 patients) or Milligan-Morgan hemorrhoidectomy (40 patients). The hemorrhoidal pedicle was coagulated with LigaSure in the LigaSure group and transfixed with 2/0 vicryl in Milligan-Morgan method.

Results
In comparison with Milligan-Morgan method, LigaSure hemorrhoidectomy had a shorter operating time (P<0.001 and was highly statistically significant), less blood loss (P<0.01 and was highly statistically significant), less postoperative pain (highly significant test P<0.01), postoperative complications including hemorrhage (15 vs. 0.0% at 5 days), urinary retention (P=0.169), and faster wound healing at 7 weeks.

Conclusion
Because of its ease of use and less postoperative pain and complication, LigaSure hemorrhoidectomy can be performed as a day-care procedure with less incidence of postoperative complications than Milligan-Morgan method.
Use of prophylactic mesh for prevention of incisional hernia following midline laparotomy
Authors: Mohamed Sawsan S. , Alfy Mohamed O. 
Published: March 2024

Background
Incisional hernias (IH) following abdominal surgery are frequent and morbid. Prophylactic mesh placement may significantly reduce IH but is not widely used. This study aimed to assess the safety and efficacy of prophylactic mesh placement in preventing IH development after midline laparotomy.

Patients and methods
This was a prospective observational study on 83 patients undergoing midline laparotomy admitted to our hospital during the period from August 2017 to January 2020. The patients were randomized into two groups: the suture group (SG), with nonabsorbable running sutures, and the prophylactic mesh group, with fascial closure as in the SG but reinforced with onlay polypropylene mesh.

Results
There was no significant difference observed in mean age, sex, mean BMI, mean hospital stay, and mean follow-up period between both the groups. A statistically significant reduction in IH incidence was demonstrated in the mesh group, with one (2.56%) case, than in the SG, with 11 (25.0%) cases. Surgical site occurrence had higher incidences in the mesh group (25.64%) than in the SG (6.82%).

Conclusion
Reinforcement of the midline closure by onlay mesh has been proved to be an effective and safe method for avoidance of IH in high-risk patients in both elective and emergency operations during the follow-up period.
Comparative study between tracheal ultrasound and pleural ultrasound for confirmation of endotracheal tube position
Authors: Amin Mohamed A. , Abdelraouf Hesham S. , Ahmed Abdullah H. 
Published: March 2024

Background and aim
Ensuring the correct position of the endotracheal tube (ETT) at the right time can make a big difference in patient safety. Ultrasonography (USG) has become an essential element in the field of anesthesia and intensive care. The primary outcome of this study was to measure the time needed for confirmation of proper placement of ETT using tracheal ultrasonography (TUS) and pleural USG, whereas secondary outcome was evaluation the accuracy of USG for that purpose.

Patients and methods
This study was conducted on 80 patients with physical status American Society of Anesthesiologists I–II, aged 20–60 years, of both sexes, and subjected to elective surgery requiring ETT for general anesthesia. Patients were randomly assigned into two equal groups according to the ultrasound technique, which was used for identifying endotracheal intubation, in addition to routine use of auscultation and capnography in all patients. Groups are group T, in which USG was used for visualization of ‘comet tail sign,’ and group P, in which USG was used for visualization of ‘sliding lung sign’ on bilateral lung fields. The time needed for confirmation of tracheal intubation by USG, auscultation, and capnography was recorded for each group.

Results
The time needed by TUS in group T (7.90±0.84 s) was less than that needed by pleural ultrasound in group P [14.39±1.47 s (P<0.001)] and less than auscultation and capnography in both groups. The accuracy was 92.5 and 87.5% for USG technique in groups T and P, respectively.

Conclusion
USG is a rapid technique for identification of ETT placement. The time taken for detection of ETT position was less in case of TUS than other methods. Both tracheal and pleural ultrasounds are reliable methods in detecting the proper positioning of ETT.
Evaluation of serum magnesium level in patients with type 2 diabetes mellitus with and without diabetic retinopathy
Authors: Amer Sara A.E.A.E. , ALAshry Samia H. , Saleh Nashwa M.L. 
Published: March 2024

Background
Diabetes mellitus (DM) is a worldwide, growing epidemic, with an estimated 415 million adults globally. Patients with diabetes are at increased risk of death and a triad of serious diabetes-specific complications (neuropathy, nephropathy, and retinopathy) and other associated complications. So, it becomes important to prioritize research on prevention and primary care of diabetic complications. Poor glycemic control has been associated with retinopathy. Hence, we evaluated serum magnesium level in type 2 DM with and without retinopathy. Magnesium is an intracellular cation and coenzyme for various reactions of glycolytic pathway, so hypomagnesemia has been shown to precipitate hyperglycemia.

Objectives
To assess serum magnesium level in type 2 diabetic patients and its correlation with retinopathy.

Patients and methods
This is a cross-sectional study that was carried out on 25 patients of type 2 diabetes with retinopathy and 25 patients of type 2 diabetes without retinopathy attending ophthalmology clinic of Al-Zahraa University Hospital. All patients were subjected to the following: detailed history taking, full ophthalmological examination, and investigations like fundus fluorescein angiography and serum magnesium.

Results
The results of the study revealed that there was a significant more decrease in serum magnesium level in diabetic patients with retinopathy than diabetic patients without retinopathy (P=0.028).

Conclusion
As magnesium level decreases in patients with type 2 DM, the prevalence of retinopathy increases. Hypomagnesemia correlated significantly with glycated hemoglobin. Timely monitoring of serum magnesium levels and glycated hemoglobin as well as appropriate interventions would be beneficial in early detection and treatment of diabetic retinopathy.
Comparative study between endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in diagnosis of biliary obstruction
Authors: Salama Saham M. , Elaziz Mona R. Abd , Alfathah Sabry Abd , Elgendy Naglaa A. 
Published: March 2024

Introduction
Endoscopic ultrasound (EUS) is a diagnostic procedure that continues to have greater clinical applications. EUS performed before endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice can reduce morbidity and mortality.

Aim
This study aimed to compare the diagnostic accuracy of both EUS and ERCP as combined or individual procedures in 30 patients diagnosed with biliary obstruction.

Patients and methods
From January 2017 to December 2019 in Al Azhar University Hospitals in Cairo, we recruited 30 patients with obstructive jaundice. All the patients underwent clinical examination, laboratory investigations, and abdominal US followed by EUS and ERCP procedures at the same session, and EUS findings were compared with that of ERCP.

Results
The diagnostic accuracy of EUS was as follows: choledocholithiasis in 92%, and malignant lesions in 95%. EUS showed pathology in 47.3% of patients who had an unknown pathology in biliary system at initial investigations. The overall diagnostic performance of EUS shows that the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 90.9, 89, 91.7, 95, and 93.5%, respectively. Regarding common bile duct stone (s), by ERCP, it was present in 13 (43.3%) cases, whereas by EUS, it was present in 12 (40%) cases. Regarding malignant lesions (ampullary tumor, cholangiocarcinoma, and pancreatic tumor), by ERCP, they were present in four (13.3%), seven (23.3%), three (10%) cases, respectively, whereas by EUS, they were present in five (16.6), six (20%), and five (16.6) cases, respectively. The complication rate was 3.3%.

Conclusions
EUS established high diagnostic accuracy in diagnosing the causes of obstructive jaundice, with no statistically significant difference between ERCP and EUS findings. This accurately guided ERCP need and avoided needless ERCP. EUS and ERCP in a single session for treatment of obstructive jaundice is scientifically valuable.
Bone mineral density in relation to polycystic ovary syndrome
Authors: Fawzy Olfat , Elghaffar Nagwa A. , Mahmoud Eman , Helmy Abeer 
Published: March 2024

Background and aim
Polycystic ovary syndrome (PCOS) is a complex metabolic and endocrine disorder. The influence of different metabolic and endocrine changes in women with PCOS and their relevance to bone status remains to be documented. Irisin is a newly identified adipo-myokine, which may play a role in the etiopathogenesis of PCOS as well as bone metabolism. The aim of the study was to assess bone mineral density (BMD) and serum irisin level in women with PCOS and to determine BMD relationship with irisin and other hormonal parameters.

Patients and methods
The study enrolled 80 women of reproductive age having PCOS and 15 age-matched and BMI-matched healthy women to serve as controls. A metabolic panel, reproductive hormones, and serum irisin level were measured. In addition, BMD of the spine and femur was also assessed using dual-energy X-ray absorptiometry.

Results
Serum irisin level, fasting insulin, and homeostatic model assessment of insulin resistance were significantly higher in the PCOS group compared with the control group. Receiver operating characteristic curve for serum irisin was done for the PCOS group and the control group and demonstrated that the cut-off value for serum irisin was 0.161 μg /dl. There was also a statistically significant difference between the PCOS group and the control group in BMD of spine and femur, being higher in the PCOS group. Logistic regression analysis has shown that serum irisin level, waist circumference, and fasting serum insulin were predictors for the z-score of spine in the PCOS group.

Conclusion
Serum irisin level may be considered as a novel biomarker for PCOS diagnosis. Circulating irisin in PCOS is strongly related to BMD. This suggests that irisin as an adipo-myokine may also be associated with bone metabolism.
Effect of intradialytic exercise on quality of life of patients with end-stage renal disease on hemodialysis
Authors: Ali Noha H. , Eltokhy Hanan M. , Hassan Maha A. , El-Nahas Nesreen G. 
Published: March 2024

Background
Up to 90% of patients diagnosed with end-stage renal disease (ESRD) regularly receive hemodialysis (HD) as renal replacement therapy. Patients with ESRD have a diminished physical function, so physical therapy during HD sessions can be a significant part of physical rehabilitation for these patients. The improvement in quality of life (QoL) is regarded as a main target in the management of patients with ESRD.

Aim
The aim of the study was to evaluate the effect of a physical therapy program on the QoL in patients with ESRD on HD.

Patients and methods
This sectional study was conducted on 60 ESRD patients on regular HD who are allocated from the HD unit, Internal Medicine Department of El-Zahraa University Hospital from March 2018 to August 2018. The patients were subjected to anthropometric measurements including weight, height, and BMI; all laboratory variables were recorded. The QoL was assessed using the short-form 36 questionnaire and the score was calculated at the beginning of the study and after 6 months.

Results
There was a statistically significant decrease in blood urea (49.54±15.62 to 33.92±13.89) and plasma creatinine (6.19±1.43 to 4.20±1.95) after 6 months of starting intradialytic exercise in comparison to the baseline. There is statistically significant improvement in the results of some items of the short-form 36 health questionnaire after 6 months from the start of the study.

Conclusion
Exercise program during the intradialytic period can provide a significant improvement of QoL and physical ability of patients with chronic kidney disease.