bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Affecting Antihypertensive Adverse Drug Reaction among Chronic Kidney Disease Patients
Authors: Nasiruddin Aina Yazrin Ali , Lee Fei Yee , Makmor-Bakry Mohd , Islahudin Farida 
Published: January 2024

ABSTRACT

Context:
Chronic kidney disease (CKD) patients are frequently prescribed antihypertensives to slow the progression of the disease through the reduction of proteinuria and controlled blood pressure (BP). Antihypertensives often cause adverse drug reactions (ADRs) such as hyperkalemia, dry cough, and dizziness, to name a few. However, there is a lack of work in determining clinical and genetic factors associated with ADR among CKD patients.

Aims:
This work aimed to determine the clinical and genetic factors associated with ADR among CKD patients.

Settings and Design:
A prospective observational cohort study was performed in tertiary hospitals.

Subjects and Methods:
CKD patients >18 years, on at least one antihypertensive, with a follow-up for 1 year were included. Blood samples were collected for the identification of CYP2C19*2, CYP2D6*10, and CYP3A5*3.

Statistical Analysis Used:
A simple and multiple logistic regression was performed to determine factors associated with ADR.

Results:
A total of 188 patients were included. The most common antihypertensive used was renin–angiotensin–aldosterone system inhibitors (n = 148, 78.7%), which were found to cause most of the ADR (n = 15, 48.4%). Factors associated with ADR were female (adjusted odds ratio [AOR] =0.29, 95% confidence interval [CI] = 0.09–0.96; P = 0.04), nonsmokers (AOR = 0.19, 95% CI = 0.04–0.91, P = 0.04), and systolic BP (SBP) >138 mmHg (AOR = 0.19, 95% CI = 0.06–0.58, P < 0.01). An ADR was 3.4, 5.1, and 5.4 times more likely to occur among males, nonsmokers, and an SBP <138 mmHg, respectively (χ
2
[13] = 28.9, P = 0.007).

Conclusions:
Closer monitoring of ADR should be performed among CKD hypertensive patients to ensure optimized management. Further work on demographic, clinical, and genetic polymorphisms should be performed in future studies regarding antihypertensive ADR.
Role of NT-pro B-type Natriuretic Peptide in Anemic Patients Presenting with High-output Cardiac Failure
Authors: Roushan Kumar , Raj Akshi , Singh Madhuri , Chandanwale Shirish Sahebrao , Sharma Anuj 
Published: January 2024

ABSTRACT

Background:
Anemia commonly contributes to cardiovascular alterations, including heart failure (HF). High-output cardiac failure is a less common form of HF, characterized by heart’s inability to provide sufficient blood for the body’s demand. However, anemia sometimes remains undetected because the superficial cardiac function does not precisely reflect the adverse impact of anemia. Plasma B-type natriuretic peptide (BNP) is comes into role in these cases.

Material and Method:
This cross sectional study was conducted between August 2020 to September 2022 on 40 severe anaemic cases with Hb < 8g/dl according to WHO classification irrespective of etiology with clinical signs of heart failure, age group- above 14 years.

Results:
Out of total 40 patients, 24 were male and 16 were female. In our study, among the anemic females, 9 (56%) belonged to the age group of <30 years of age. In our study, out of 40 patients, 14 patients presented with high BNP and 26 patients presented with BNP within normal limits. The mean BNP range in patients with high BNP level was 290.6.

Conclusion:
Understanding the mechanisms of association between anemia and NT-proBNP may improve our understanding of cardiac pathophysiology and help target potential therapies to prevent the development and progression of HF.
Polycystic Ovary Syndrome
Authors: Shailaja K. , Ravindranathan Shruthi , Jayanii V. T. , Jinnah Aadhira , Shirly S. 
Published: January 2024

ABSTRACTPolycystic ovary syndrome (PCOS) is a most common but complex, multifunctional, endocrine complaint that occurs substantially in women of reproductive age. It is characterized by irregularity or the absence of ovulation and elevated situations of androgen (hyperandrogenism) and insulin (hyperinsulinemia). It is a chronic condition that can lead to numerous successive and severe conditions such as uterine (endometrial) or ovarian carcinoma, diabetes mellitus, and cardiovascular diseases. The signs and symptoms of polycystic ovary disease may include irregular periods, infertility, weight gain, thinning crown hair, patient acne, dark skin patches, skin markers, pelvic pain, depression, and anxiety. Remaining benighted on PCOS and its management impacts the prognosis.
Evidence-based Clinical Efficacy of Certain Indigenous Traditional Siddha Formulations in Combating Anemia: A Global Health Burden – A Systematic Review and Meta-analysis
Authors: Kumar A. Rajendra , Gunalan Gayathri , Firdouse K. Hina , Archana A. 
Published: January 2024

ABSTRACT

Background:
Anemia is a widespread issue impacting the well-being of millions and their quality of life. It also hinders the growth and learning of children, which can detrimentally affect a nation’s progress. In Siddha System of medicine, various pharmaceutical formulations are available for anemia treatment. However, there is a lack of evidence-based clinical trial data supporting these traditional Siddha claims.

Aim and Objective:
This study aimed to conduct an extensive meta-analysis to assess the therapeutic effectiveness of Siddha formulations in anemia management and also to evaluate the clinical evidence’s validity.

Materials and Methods:
The study gathered data from various sources, showcasing the use of different Siddha preparations in clinical studies for anemia treatment. Rev-Man 5.2 software was used for meta-analysis. The study revealed a significant improvement in both adults and paediatric groups after treatment with various Siddha formulations.

Results:
The meta-analysis showed a standardized mean difference (SMD) of 1.92 for haemoglobin level before and after treatment over an average period of 44 ± 20 days (P≤0.0001).

Conclusion:
This analysis demonstrates that Siddha formulations have substantial evidence-based therapeutic efficacy in treating anemia. These Siddha formulations hold promise for inclusion in public health programs and policies aimed at combating anemia in the population. However, conducting more randomized control trials (RCTs) in anemia treatment is essential to establish robust scientific evidence which potentially leads to global acceptance of these Siddha formulations.
Etiological Spectrum, Epidemiological Characteristics in Compensated and Decompensated Cirrhosis at First Presentation
Authors: Bini Balakrishnan , Vijayalakshmi B. , Shenoy K. T. , Mukkadan Joseph Kurian 
Published: January 2024

ABSTRACT

Context and Aim:
Decompensation as a presenting feature is uncommon among cirrhosis-seeking consultations and may indicate the poor outcomes. This study will be assessing the etiology and epidemiological characteristics among compensated and decompensated cirrhosis at first presentation.

Settings and Design:
A cross-sectional study in a tertiary care hospital in south Kerala, India.

Subjects and Methods:
Two hundred and nine patients with liver cirrhosis were evaluated for: age at presentation to the hospital, biochemical, virologic, Child–Pugh and Model for end-stage liver disease (MELD), and MELD Sodium (MELD Na) scores. Using cutoff for MELD Na and Child scores A versus B and C, the degree of association in those with or without decompensation was evaluated.

Results:
The mean (standard deviation) age of participants was 58.24 (±9.9) years. Seventy-seven percent were males. 11.5% were with decompensated cirrhosis (DC). 61.2% had alcoholic liver disease (ALD); 8.1% had hepatitis B; 2.4% hepatitis C virus; 0.5% autoimmune hepatitis; and 27.8% had nonalcoholic steatohepatitis (NASH). In compensated cirrhosis (CC), 60.5% had ALD and 28.1% (n = 52) had NASH, whereas, in those with decompensation, 66.7% had ALD and 25% had NASH. In CC, 54.1% were Child A and the rest B and C compared to DC, wherein 58.3% were with Child B and C and 41.7% in Child A. MELD Score of 9+ was more in DC compared to CC (P = 0.05). Alcoholic hepatitis was observed in 32% of DC.

Conclusions:
Decompensation was the presenting feature in 11.5%, and alcohol abuse was the major risk factor. Those with DC have higher MELD scores.
Role of color Doppler ultrasound in differentiation between benign and malignant lymphadenopathy
Authors: Gendy Mina Gergis Naeem , Hussein Mostafa Thabet , Gad Shimaa Farghaly 
Published: January 2024

Objective
To evaluate the accuracy of color Doppler ultrasound in differentiation between benign and malignant enlarged lymph nodes compared with histopathological correlation.

Patients and methods
In all, 100 patients with lymphadenopathy in various age groups participated in this prospective study. Grayscale and color Doppler ultrasound (CDUS) was done for all of them, and then a comparison with histopathological data was done.

Results
Grayscale ultrasound had 88.9% sensitivity and 100% specificity with an area under the curve of 0.94 in the prediction of malignant LNs, while CDUS had 100% sensitivity and 87.8% specificity with an area under the curve of 0.93, The pulsatile index at a cutoff point >1.39 had 77.8% sensitivity and 100% specificity in the prediction of malignant LNs with an area under the curve of 0.87, while the resistive index at a cutoff point >0.69 had 78% sensitivity and 100% specificity with an area under the curve of 0.89.

Conclusion
Differentiation between benign and malignant lymph nodes using CDUS is a reliable and noninvasive technique.
Ozaki procedure
Authors: Ahmed Ahmed G. T. , El-Minshawy Ahmed M. K. , Caputo Massimo , Biglino Giovanni , Ismail Ahmed M. T. , Ibrahim Ahmed I. A. 
Published: January 2024

Background and aim
Mechanical heart valves require lifelong anticoagulation and therefore predispose to hemorrhagic events. Ozaki developed their aortic valve (AV) reconstruction technique at Toho University Ohashi Medical Center, where they standardized the use of glutaraldehyde-treated autologous pericardium to perform a trileaflet aortic valve. Therefore, it achieves maximum effective orifice area (EOA) and low transvalvular gradients. The current study aimed to assess the short-term Ozaki procedure in our center.

Patients and methods
A total of 86 patients were enrolled in the current study; group A included 43 patients who had undergone AVR using a biological aortic valve prosthesis, and group B included 43 patients who had undergone aortic valve replacement (AVR) using the Ozaki procedure.

Results
Both groups had comparable findings either at baseline, perioperative data, or during the follow-up. During follow-up either in the 3rd or 6th month both groups had insignificant differences. Renal dysfunction was reported in five (11.6%) patients of the biological valve group and two patients of the Ozaki group. Endocarditis was developed in only two patients with biological valves. Mild aortic regurgitation was noticed in one patient in the 3rd month and two patients in the 6th month in the case of the Ozaki procedure, while only one patient in the biological valve group developed mild AR in the 6th month of follow-up. Nearly all patients had improved NYHA classes in both groups. No patient in the Ozaki group was converted to AVR.

Conclusion
We have described our initial experience with the Ozaki procedure in adults. The current study reported promising results for the Ozaki procedure. Yet, multiple future studies in multiple centers are warranted to draw a firm conclusion and support our findings.
Pentacam findings after implantation of intrastromal corneal rings in keratoconus
Authors: Shaltout Hebatullah S. G. , Elsedfy Hany O. , Awade Abd EL.Nasser , Mostafa Magdi M. , Abdel- Radi Mahmoud 
Published: January 2024

IntroductionIntrastromal corneal ring segment implantation is a minimally invasive procedure. Its main goals are to flatten and regularize the cornea, to improve uncorrected and corrected visual acuity, and to delay or even prevent a keratoplasty. ICRSs effect correlates directly to its thickness and inversely to its distance to the visual axis.Patients and methodsA retrospective observational study involving 44 eyes of 44 patients was initiated. The files and pentacam printouts of 44 patients were retrospectively extracted and evaluated. The preoperative and postoperative ocular findings and pentacam parameters of anterior and posterior corneal surfaces, in addition to the pachymetry data, were recorded and analyzed.ResultsForty-four patients with keratoconus were evaluated in this study. Evaluation of anterior corneal surface showed significant flattening of all keratometry readings (P< 0.001) with significant improvement of corneal astigmatism (P= 0.03), corneal asphercity(P< 0.001), the inferior-superior asymmetry(P= 0.019) and the front elevation(P= 0.005) The posterior corneal surface showed significant improvement in back elevation(P< 0.001), and the back surface asphercity showed significant prolate shift (P= 0.01). The thinnest location was significantly upward displaced towards the corneal apex. kera 355° showed a significant flattening of all keratometry readings with significant improvement of corneal astigmatism and corneal asphercity of the anterior corneal surface and the back surface asphercity showed significant prolate shift(P= 0.001). The ICRS showed a significant flattening of km(P= 0.030) and corneal asphercity of the anterior corneal surface(P= 0.046).ConclusionThe intracorneal ring implantation led to improvement of the tomographic corneal parameters which was more significant at the anterior corneal surface.
Clinical audit on medical treatment of infective endocarditis in Assiut University Children’s Hospital
Authors: Mohammed Nagwa A. , Zaki Basem S. , Ahmed Faisal A. 
Published: January 2024

Background
Despite advances in diagnostic tools and therapy approaches over the last few decades, pediatric infective endocarditis (IE) remains a complicated condition. IE is associated with considerable morbidity and death.

Aim of the work
This research aims to revise the medical treatment of pediatric patients with IE who were admitted to the Cardiology Unit at Assiut University Children Hospital (AUCH) and how much it is adherent to the international guidelines of American Heart Association (AHA), in addition, to evaluate their outcome.

Subjects and methods
This clinical audit was conducted on 30 pediatric patients with IE who were admitted to the Pediatric Cardiology Unit, AUCH, Egypt from March 2020 to February 2021. In all, 76.7% of enrolled cases with IE received vancomycin 40 mg/kg per 24 h IV in 2 or 3 divided doses and 23.3% received Ceftriaxone at a dose of 100 mg/kg per dose IV or IM daily. Then the treatment was modified according to the blood culture sensitivity test for at least 4 weeks and up to 6–8 weeks in some cases. Transthoracic echocardiography (TTE) was performed for all cases at the beginning, and after finishing the treatment protocol. Evaluation for the development of complications among the studied cases was done.

Results
The median age of the studied participants was 7 years, 83.3% were males. According to Modified Duke Criteria, 73.3% had a definite diagnosis of IE, and 26.7% had a possible diagnosis of IE. All studied cases received immediate assessment, and general and systematic examination. The echocardiographic examination which was done revealed that 83.0% of the studied participants have no valvular lesions. After receiving the empirical treatment, all studied patients received antibiotic therapy according to the blood culture and sensitivity test results. A significant decrease in IVSD, LVESD, LVPWD diameters, and thickness, and a significant improvement in left ventricular systolic function (LVEF and LVFS) was observed in IE patients after receiving treatment. Other cardiac diameters show improvement but do not reach a significant level. Also, the vegetation size shows a significant reduction. Regarding the final outcome of the IE patients who were admitted to AUCH, 53.3% achieved recovery while 46.7% deteriorated.

Conclusion
The international guidelines for the management of IE-diseased children were successfully followed by the Cardiac Unit of AUCH, on average, 85.0% (as we used ceftriaxone as an empirical treatment which is not recommended by AHA), and are associated with a high success rate.
Evaluation of children with syncope
Authors: El_deen Zeinab M. , Nazeer Merna E. , Ahmed Faisal A. 
Published: January 2024

Background
Syncope is one of the most prevalent paroxysmal disorders in children and adolescents. It is a transient, self-limited loss of conscious and postural tone that is followed by a full recovery spontaneously and without any neurological consequences.

Aim
The objective of this internal audit is to assess how much the staff at Assiut University Children Hospital (AUCH) are sticking to the agreed upon unit’s protocol regarding how to deal with children or adolescent with syncopal attacks.

Patients and methods
This clinical audit was conducted on 150 pediatric patients with syncope who were admitted to Assiut University Children Hospital, Egypt during the period from the start of January 2021 up to the end of June 2022. Data was systematically collected regarding medical history, general, and systematic examination including chest, cardiac, abdominal, and neurological examination. Duration of syncopal attack (minutes), prodrome history, related symptoms (as chest pain or palpitations), and triggers (as hyperventilation, pain, stress, or effort) were all collected.

Results
The mean age of the studied participants was 11.96 ± 2.47 years (range 1.5–15 years), with slight female sex predominance. The neurocardiogenic causes (vasovagal, VVS) were the main cause for syncopal attacks among our studied cases, followed by neurologic causes in 17.3%. Collectively, we could say that our institution is successfully following the recommended protocol of our institution for the management of syncopal attacks in children and adolescents.

Conclusion
The recommended protocol of our institution for the management of syncopal attacks in children and adolescents was successfully followed by the staff members at Assiut University Children Hospital.
Assessment of routine use of critical view of safety in laparoscopic cholecystectomy, prospective cohort study
Authors: Sayed Mostafa M. , Ewees Mohammed K. , Romany Abanoub K. Henry 
Published: January 2024

Background
The reported frequency of biliary injuries has tripled to 0.4% since the advent and widespread usage of laparoscopic cholecystectomy in the 1990s. The goal of this study: in terms of practicality and safety, is to evaluate the effectiveness of a critical perspective on safety during laparoscopic cholecystectomy.

Patients and Methods
This prospective cohort research included 100 patients who received laparoscopic cholecystectomy between 2018 and 2021 at Assiut University Hospital and Assiut Police Hospital.

Results
According to the data, just one individual out of 100 suffered from bleeding, another from a bile leak, and no one suffered from liver or viscus damage.

Conclusion
The most secure approach to comprehend the triangle’s design is from the vital aspect of safety, and understanding so significantly aids in the prevention of ductal harm. Significant bile duct damage and accompanying complications may be avoided by employing Critical View of Safety in clinical practice.
Prevalence, correlates, and treatment gap of mental illnesses among middle age and elderly population of India
Authors: Jana Animesh , Verma Priyanka , Sinha Abhinav , Kanungo Srikanta , Pati Sanghamitra 
Published: January 2024

Introduction:Mental health issues are increasing globally and low- and middle-income countries contribute 80% of the total burden. In India, the proportion of mental illnesses contributing to the total disease burden has become twofold since 1990. Despite this high prevalence, a greater part of the affected people are deprived of proper care. Henceforth, this study was planned to estimate the prevalence of mental illnesses among middle age and older adults of India and determining the treatment gap across people suffering from various mental illnesses.Methods:A cross-sectional analytical study was conducted using the data from Longitudinal Aging Study in India Wave I, (2017–2018). Regression analysis was done to understand the association of mental illness with different sociodemographic factors. Ninety-five percentage confidence interval were considered a measure of uncertainty.Results:The prevalence of mental illness was found to be 31.23%. About 65.67% of the participants having Alzheimer’s/dementia and 61.06% of the participants having depression were not receiving any treatment. Females, smokers, nonworking, participants with no formal education, and those living without partner are found to be at higher risk of developing mental illness.Conclusion:A larger proportion of the middle age and older adults in India are affected with mental illnesses and the majority of them are left untreated. Failing to overcome this, treatment gap can cause a rise in indirect economic cost leading to poverty. Therefore, it is imperative for India to invest more on mental health services.
The profile of patients with undiagnosed type 2 diabetes mellitus in urban communities, South Trinidad, 2019–2020
Authors: Dharamraj Kavita , Jogie Jeremy , Chang Christopher , Rampaul Sarah , Roopchan Dylon , Ramlal Daniella , Wong Darien 
Published: January 2024

Aim:
The aim is to profile patients with undiagnosed type 2 diabetes (T2D) mellitus in urban communities in South Trinidad, 2019–2020.

Settings and Design:
This cross-sectional study took place in grocery stores and malls in urban communities, in South Trinidad, from November 2019 to January 2020.

Subjects and Methods:
Adults between the ages of 40–60, body mass index ≥23 kg/m2; undiagnosed with T2D, and who gave informed consent were enrolled in the study, through convenience sampling (n = 86). The main outcome measures were glycemic states that were assessed using glycated hemoglobin clinical cut points of <5.7%, 5.7%–6.4%, and ≥6.5%. Differences in demographic, socio-economic, risk factors, and clinical measurements among glycemic states were compared using Chi-square test for categorical data and one-way ANOVA for continuous nonparametric data.

Results:
Eighty-six participants were included in the analysis: 54.7% were normoglycemic; 33.7% prediabetic and 11.6% were newly diagnosed diabetics. The mean (standard deviation) age was 50.36 (6.36), with more females (77.91%) and East Indians (56.98%). Hypertension was the most common comorbidity seen, 29.07%. Sixty percent of persons had a first-degree family history of T2D mellitus. At high risk for developing a chronic noncommunicable disease: 67.44% of females with a waist:hip ratio >0.85 and 19.77% of males with a waist:hip ratio >0.9. Alcohol consumption was linked to higher glycemic states (P = 0.045). However, no statistically significant correlations were found between all other risk factors assessed and glycemic states.

Conclusion:
There were no statistically significant associations for risk factors, except for alcohol consumption, among glycemic states.