bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical experience and management outcome of WHO grade II pediatric intramedullary ependymomas: A descriptive study
Authors: Singh Yashveer , Maurya Ved P , Srivastava Arun K , Das Kuntal K , Bhaisora Kamlesh S , Sardhara Jayesh , Verma Pawan K , Mehrotra Anant , Jaiswal Awadhesh K , Behari Sanjay , Mishra Prabhaker , Agrawal Sushma 
Published: February 2024

Abstract

Background:
Intramedullary ependymom‑a is a rare primary tumor in the pediatric population. The World Health Organization (WHO) grade II pediatric intramedullary ependymoma (PIME) is the most common in frequency, though it is a less discussed pathological grade. This study aims at sharing the clinical experience and management outcome of WHO grade II PIME from a tertiary care center.

Materials and Methods:
The clinico-radiological details of all histologically proven, newly diagnosed primary PIME that underwent management were collected. Recurrent lesions and other spinal cord tumors were excluded. Details of surgical intervention and follow-up visits were reviewed from the record-keeping system. The surgical nuances and outcome predictors in the form of functional grade were analyzed. The statistical data were calculated by using the appropriate statistical tests.

Results:
The mean age of the study population was 16.3 ± 4.0 years. The male-to-female ratio was 2:1. The pain was noticed in 14 patients (14/18 [77.8%]), and four (22.2%) patients were ambulant at the time of admission. Overall, 15 (83.3%) patients underwent total excision, and subtotal excision was achieved in three patients. The median follow-up period was 31.0 months, and the range was 2–126 months. After surgical decompression of tumor, there was a significant improvement in the modified McCormick’s grade, when median score was compared between preoperative period and the last follow-up visits (4 [2.8–4] vs. 2 [2–3], P = 0.001). There was one case of surgical mortality, with two symptomatic recurrences after surgical resection.

Conclusions:
The progression-free survival (PFS) and overall survival (OS) depend on early excision at better functional status. Age, gender, and vertical extension of tumor have a debatable impact on the overall outcome in PIME.
Prevalence, Metabolic Consequences of Non Alcoholic Fatty Liver Disease (NAFLD) and its Association with Microvascular Complications and Ventricular Dysfunction in Patients with Type 2 Diabetes Mellitus
Authors: Sahoo Nihar Ranjan , Dalai Motij Kumar , Dash Deepak Kumar , Sethy Ganeswar 
Published: February 2024

ABSTRACT

Objective:
To study the prevalence of non-alcoholic fatty liver disease (NAFLD) and its association of with microvascular complications and ventricular dysfunction in patients with type 2 diabetes mellitus (T2DM).

Methods:
In this cross-sectional study, 100 T2DM patients were screened randomly for detection of fatty liver in ultrasonography. Patients with fatty liver (NAFLD group, n = 36) were compared with subjects without fatty liver (non-NAFLD group, n = 64). Detailed clinical, biochemical, and imaging parameters like lipid profile, LFT, fasting plasma glucose, 2-hour post-prandial plasma glucose, HbA1C, fasting insulin, spot urinary albumin/creatinine ratio, and 2-D ECHO (M-mode) were performed.

Results:
The prevalence of NAFLD was found to be 36%. NAFLD group had significantly higher BMI, WHR, blood pressure, glycemic profile, and lipid parameters compared to non-NAFLD group. HOMA IR was elevated significantly in NAFLD group (3.16 ± 1.96) compared to non-NAFLD group (1.73 ± 1.59). There was significantly higher prevalence of all the diabetes-related microvascular complications and LV diastolic dysfunction in NAFLD patients with higher odds for the occurrence of neuropathy (OR = 4.74; P = 0.001), nephropathy (OR = 3.92; P = 0.003), retinopathy (OR = 5.95; P = 0.002), and LV diastolic dysfunction (OR = 1.84; P = 0.043).

Conclusions:
NAFLD is significantly associated with various diabetes-related microvascular complications as well as LV diastolic dysfunction in T2DM patients.
A Single-center, Seven Years Retrospective Study to Analyze the Outcomes of Acute Upper Limb Ischemia (AULI) in Northern India
Authors: Tripathy GN , Basra Sharanjit S. , Hiremath Ravishekar N. , Ghodke Sandhya , Verma Vishal , Mittal Mohit 
Published: February 2024

ABSTRACT

Background:
Acute upper-limb ischemia (AULI) is not always as limb-threatening as those in the leg, so thrombo-embolectomy is not always as necessary for limb salvage.

Objective:
To evaluate “the outcomes of limb and life at the end of one month, in patients with AULI” and to analyze the following factors: presentation from the time of the acute event, evaluation of limb at the time of presentation regarding its viability, and compare the outcomes in early presentation vs late presentation.

Methodology:
This was a retrospective study; hence, clinical profiles of all patients during the past seven years were reviewed for those presenting with AULI. Data on anticoagulation were collected, imaging and operative procedures were extracted. All statistical analyses were performed using SPSS 11.0 for Windows.

Results:
In our study, 25 (42.4%) patients were included due to native arterial thrombosis, 11 (18.6%) due to embolic disease, and the same percentage due to exposure to a high-altitude area (HAA) (more than 9000 feet). 4 (6.8%) patients had thoracic outlet syndrome and cervical rib, and 5 (8.5%) had hypercoagulable disorder. Our study population was younger with a mean of 44.9 years with an SD of 13, and the majority were male (5 out of 59 were female). 16 were active smokers, and 2 were former smokers. The left upper limb incidence was 59% (n = 35), and the right upper limb was 41% (n = 24). In our study, the most common site was the brachial artery 53% (26 out of 49) and axillary artery 35% (17 out of 49) when iatrogenic, traumatic, and thoracic outlet syndromes are excluded. Out of the 59 patients, 39 patients had undergone color Doppler flow imaging of the affected limb and 30 patients had undergone CT angiography of the arch and the limb. Two patients presented with gangrene to the forearm, and 12 patients underwent Colour doppler flow imaging (CDFI) before they presented to our center. In our study, 37% of the patients presented within 48 hours of the onset of symptoms, out of which above-elbow amputation was done in only 1 patient, that is, 4.5%, and 24% of the patients presented within an 8–14-day period, among which one patient (11%) had undergone above-elbow amputation and 22% of the patients presented after 14 days, in which there were 2 above-elbow-amputation patients (15%) with a statistically non-significant P value of 0.5. A total of 45 patients were managed with anticoagulation. A detailed discussion on the treatment outcome of each case has been presented in the article.

Conclusion:
CT angiography, when available, is a well-accepted first-line investigation for AULI. When we compare AULI with lower-limb ischemia, collateral circulation conservative management is also an option, provided that it is not associated with tissue loss. AULI like lower-limb ischemia has better limb salvage when diagnosed and intervened early.
A Phenomenological Study on Lived Experiences of Adolescents with Specific Learning Disability (SLD)
Authors: Tidiya Maryelizabeth , George Anice , Nayak Malathi G. 
Published: February 2024

ABSTRACT

Introduction:
Specific Learning Disability (SLD) is a self-limiting disorder that can contribute to many psychological issues in school-going children. The issues in school will be misinterpreted by parents as inattentiveness, lack of interest in studies, or laziness; hence, they overpressurize the children. Understanding the child’s condition is the most challenging aspect.

Objectives:
To explore the lived experiences of adolescents with SLDs using a phenomenological approach and develop a multicomponent information brochure for adolescents, parents, and teachers of adolescents based on identified needs.

Materials and Methods:
A qualitative descriptive phenomenological design was adopted to collect the data from the adolescents visiting Composite Regional Centre for Persons with Disability, Kozhikode for the study. Adolescents who reached the institution for certification of learning disability were selected through the purposive sampling technique. Samples were assessed by the psychologist to diagnose SLD and those who met the inclusion criteria were selected. The semistructured interview schedule was prepared and validated. An in-depth interview was carried out. Data were recorded, transcribed, and translated. Open code software version 4.02 was used to code the data. Subthemes and themes were derived.

Results:
The thematic analysis of the data derived five themes: barriers, supportive social system, looking within, beyond control, and facilitators. An undesirable coping strategy being involved in a negative environment, fear factors, feeling low, frustration, ignorant support system, and feeling of guilt are the subthemes of the main theme barriers. Family support, peer support, and positive approach of teachers are the subthemes from which the theme supportive social system is derived. The theme beyond control was derived from the subthemes of almighty, state of helplessness, and looking at the future. Realistic self-appraisal, other competencies, and self-comparison with peers are the subthemes of the theme beyond control. Facilitators have the subthemes of burning desire, putting effort, and coping strategy.

Conclusion:
SLD is a neurodevelopmental disorder in which specific academic skills are compromised. As a result, the child is greatly affected and it becomes evident once they enter school age. Initial processes of learning become difficult but sometimes it remain unrecognized. Early identification can facilitate early interventions which can be a stepping stone toward the betterment of the skills. But in certain circumstances, the parents and teachers may be ignorant about the entity; thus, it remains unrecognized and thereby progress to a situation from which further learning becomes impossible.
Non-Diabetic Renal Diseases in Diabetic Patients with Emphasis on Infection-Related Glomerulonephritis
Authors: Iyer Aishwarya , Ayesha Sobiya M. , Uppin Megha , Golla Anvesh , Raju Sree Bhushan 
Published: February 2024

ABSTRACT

Background:
Non -diabetic renal diseases (NDRDs) in diabetics are treatable and therefore have better prognosis. Infection-related glomerulonephritis (IRGN) is being frequently reported as NDRD.

Objective:
We attempt to study the clinicopathologic spectrum of diabetic patients with biopsy proven IRGN.

Materials and Methods:
This was a retrospective analysis of renal biopsies performed in diabetic patients from January 2014 to June 2021. Demographic data, clinical features, and other laboratory findings were collected. The renal biopsies were classified into diabetic nephropathy (DN) and NDRD. The patients with diagnosis of IRGN were studied in detail.

Results:
Of the 1972 renal biopsies done in diabetic patients, 537 were NDRD and 1233 were DN. The commonest NDRD was tubulo-interstitial nephritis (n = 173) followed by IRGN (n = 74). The IRGN cases were in the age range of 5-78 years (median-53.5) with M: F = 3.4:1. The median duration of diabetes was six years, with median HbA1c = 7.5. Proteinuria ranged from 0.041 to 13 g/day (median = 1.95) with median serum creatinine of 3.7 mg%. History of preceding infection was present in nine cases. These patients presented with rapidly progressive renal failure (RPRF, 17), nephritic syndrome (27), nephrotic syndrome (27), and asymptomatic proteinuria (3). Median C3-level was 47 mg/dl. The biopsies showed classic endocapillary hypercellularity with neutrophils in mesangium, 45 cases had associated DN. Immunofluorescence performed in 54 cases showed coarse granular deposits of C3C.

Conclusions:
IRGN should be kept in mind in diabetic patients presenting with RPRF or nephrotic proteinuria. The biopsy and immunofluorescence helps in accurate diagnosis.
Correlation between H. Pylori and Cytomegalovirus in Adults
Authors: Hussein Aliaa Zaraa Allah , AL-Khikani Falah Hasan Obayes , Al-Hussainy Ahmed Danbous Obayes , Alshamary Rasha Salih Mahdi 
Published: February 2024

ABSTRACT

Background:
The majority of research has concentrated on H. pylori alone, ignoring the positive or negative interactions with other pathogenic microbes. A common herpesvirus that infects 40% to 70% of the general population is cytomegalovirus (CMV). So, the aim of this study was to find this possible correlation.

Materials and Methods:
This research was conducted in Babylon, Iraq, from January to March, 2022. A total of 90 people suspected with H. pylori as abdominal pain, nausea, loss of appetite, and bloating. These persons were engaged in this study divided to two groups as IgG positive H pylori (positive group) and IgG negative H pylori (negative group). Antibody screening assays on blood samples were used to look for antibodies against H. pylori. IgG antibody titer in blood samples for CMV was detected by mini vidas biomerieux. One-way ANOVA, independent T, and Chi-square tests were used to examine the data using SPSS 23 software.

Results:
The CMV titer was significantly different between negative group 52.41 ± 24.107 and positive group 70.39 ± 29.048 (P = 0.002) with positive significant correlation was found at the 0.01 level (r = 0.323; P = 0.003) between these two groups regarding CMV. Males (63.16%) were more infected with H. pylori compared to females (38.5%). Thus, the gender of males considered as a risk factor regarding this infection at odds ratio 2.74 (95% CI: 1.15-6.5; P = 0.032). Whereas, no significant difference between males 61 ± 23.85 and females 61.35 ± 30.88 was observed regarding CMV titer.

Conclusion:
Males considered as a risk factor regarding H. pylori infection at odds ratio 2.74 (P = 0.002). There is strong positive correlation between infection of H. pylori and CMV (r = 0.323; P = 0.003). The question that remains to resolve if H. pylori were favor the reactivation of latent infection by CMV or vice versa.
To Study the Effect of Prophylactic use of Tranexamic Acid in Postpartum Blood Loss after Normal Vaginal Delivery
Authors: Chawla Sushil , Siddique Nilopher , Jose Tony 
Published: February 2024

ABSTRACT

Background:
Postpartum hemorrhage is responsible for major morbidity and mortality all over the world. Uterotonics are used to prevent uterine atony and decrease blood loss after delivery. Tranexamic acid is recommended to be used to reduce the blood loss after delivery.

Materials and Methods:
Three hundred patients were studied in two groups. Control group was given standard of care and the test arm was given standard of care and injection tranexamic acid 1000 mg iv stat. The data were analyzed for the postpartum blood loss and change in the hemoglobin levels.

Results:
This randomized controlled trial showed lesser reduction in the postdelivery hemoglobin and hematocrit levels of the patients who received tranexamic acid but it was not statistically significant, but it showed significant reduction in the volume of blood loss in 6 h postdelivery period in the women receiving tranexamic acid.

Conclusions:
This randomized controlled trial showed significant reduction in the volume of blood loss in 6 h postdelivery period in the women receiving tranexamic acid.
Theory Papers for Postgraduate Examinations: Are they Utilized Optimally as an Assessment Method?
Authors: Routh Dronacharya , Datta Karuna , Lall Mahima , Prakash Jyoti , Vaidya Rajesh , Naithani Nardeep 
Published: February 2024

ABSTRACT

Introduction:
Theory papers have been the most commonly employed method to assess learning outcomes in medical education. In these papers, both recall abilities and higher-order cognitive functions need to be assessed giving proper weightage as per relevance. Hence it becomes necessary that valid assessment methods are employed to evaluate the required objectives/competencies. The objective of the study was to develop a method for analyzing postgraduate question papers of various specialties.

Methodology:
A rubric matrix was created with three broad objective criteria to assess framing and layout of the questions in each paper, analysis of different sets for same examination, and finally an overall assessment of all the papers for each subject.

Results:
A total of 28 specialty papers were available. A total number of papers analysed = 340. The overall mean score out of total 60 marks was 38.64 ± 4.5. It was seen that the majority (60%) of the departments have been graded as fair on analysis of the theory papers. None of the departments were graded as very good, while 7% of them were graded as good. Although a very minuscule percentage of the papers had grammatical errors and duplication of questions in the sets, only 57% of the departments had done a proper moderation and 21% had used higher domains of learning for assessment.

Conclusion:
Analysis of postgraduate question papers showed that the questions asked for postgraduates are more recall-based instead of higher taxonomy of cognitive domain.
Assessment of Sleep Quality among Nursing Students on Clinical Posting in a Tertiary Health Facility in North-Western Nigeria
Authors: Abubakar Muhammad Shakur , Ibrahim Halima Umar , Aliyu Ibrahim 
Published: February 2024

Abstract

Context:
The sleep quality of nursing students needs to be assessed in the context of their living conditions in order to know the best way to improve any abnormality noted.

Aim:
To assess the quality of sleep of nursing students and determine its relationship with their conditions of living among other factors.

Methods and Material:
A cross-sectional descriptive study involving nursing students on postings in a tertiary health facility. The socio-demographic data were collected with the aid of a structured questionnaire. The sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires.

Statistical Analysis Used:
Data were analyzed using the Statistical Product for Service Solution (SPSS) for Windows version 22. Chi-square (χ2) or Fisher’s exact tests were used to determine the association between sleep quality and various parameters.

Results:
The total participants were 255 with a mean age of 21.5 ± 3.4 yrs and a male to female ratio of 0.4:1. The mean sleep latency period and mean sleep duration were 21.5 ± 14.0 minutes and 6.4 ± 1.4 hours respectively. The mean ESS was 9.8 ± 3.5 indicating an increased tendency for daytime sleepiness. The mean PSQI was 6.2 ± 3.0. Seventy-three percent of the participants were poor sleepers (had scores of ≥5); 7.1% of them had a level of severity needing medical help. The quality of sleep and daytime sleepiness were significantly associated with the number of roommates and source of funding respectively.

Conclusion:
Most of the participants have poor sleep quality which is significantly associated with the number of roommates and source of funding.
Quantile Normalization for High Throughput Circulating MicroRNA Expression Study using TaqMan® Low Density Array Panels: Supporting Evidence
Authors: Ahmad Azmir , Mohamed Syarah Syamimi , Tumian Afidalina , Tolos Siti Marponga , Sivanesan Vijaya Mohan , Leman Wan Ishlah , Abdullah Kahairi , Mohamad Irfan , Wan Zainon Wan Mohd. Nazri , Rosla Luqman , Syed Yussof Sharifah Nor Ezura , Mark Paul , Mohamed@Awang Kamariah , Ramli Rosdi , Omar Eshamsol Kamar , Mohd. Yassin Mohd. Wardah , Mohamad Mohd. Amin Marwan , Kaderi Mohd. Arifin 
Published: February 2024

In searching for new biomarkers, high throughput technique has been widely used by researchers, including for gene expression study. However, the reliability and accuracy of results from high throughput study critically depends on appropriate data management, including normalization methods. Data driven normalization has been introduced as a normalization method for high throughput gene expression study. Thus, this study was conducted to evaluate the performance of various data driven and reference genes normalization methods using a high throughput circulating microRNA expression dataset. A quantification cycle (Cq) dataset generated from a high throughput circulating microRNA study was used to test the normalization methods using HTqPCR package in R software. The normalized Cq generated from different methods were compared descriptively using box plot analysis and coefficient of variance. The box plot analysis showed that quantile normalization produced more homogenous Cq distribution, lesser outliers and reduced coefficient of variance as compared to other normalization methods in screening and validation phases. The overview on quantile normalized Cq showed consistency in its level of expression before and after 2-∆∆Cq calculation indicating the reliability of quantile normalized Cq. Quantile normalization is suggested to be used in high throughput miRNA expression study due to its performance in homogenizing the data, reduce outliers and coefficient of variance.
AGRICULTURE IN BRAZIL
Authors: Matthew N. O. Sadiku  , Chandra M. M. Kotteti  , Janet O. Sadiku  
Published: February 2024

Brazil is the largest nation in terms of arable land. It has abundant land and water resources. It is among the few nations with potential to increase agricultural productivity. Access to export markets is crucial for Brazilian agriculture. Brazil is the third biggest exporter of agro-food products after the European Union and the United States. It is now regarded as a top-5 producer of 34 commodities and is the largest net exporter in the world. It is a leading comprehensive exporter of soybean, sugar, coffee, oranges, poultry, beef, cotton, corn, orange juice, and ethanol. The nation is essentially self-sufficient in basic foodstuffs. This paper introduces the reader to the practice of agriculture in Brazil.
Revisiting Lumumba’s Political Identity Through a Colonial Lens in De-Colonial Congo (1956-1965)
Authors: Quinonez Jeremy , Murillo Bianca 
Published: February 2024

In 1960, the Congolese people elected Patrice Lumumba as Prime Minister of the Congo. In 1961, after a complicated development on international events, the CIA financed Belgium troops murdered Lumumba via firing squad. This paper will focus on Belgium’s colonial attempt to use the media to attack Lumumba’s political image. From 1956-1960, it will elaborate on the rise of Belgium’s media attempts as a counter to the growing support of Lumumba’s pro-independence identity. It will then focus on this same struggle in the context of the U.N. and Ralph Bunche’s presence in the Congo. Consequently, it intersects with U.S. reaction against Lumumba’s political identity in the summer of 1960.The final section will assess Belgium, U.S. and U.N. attempts to damage Lumumba’s political identity by using the media and their political voices. The three sections will add to the strong scholarly work on Lumumba by combining the chronological approach of previous historians to interrogate a critical time period in one of many of Lumumba’s political struggles. This essay will argue that from 1955 to 1965, Belgium and the United States sought to protect their economic exploitation of the Congo by using the media to delegitimize Patrice Lumumba’s political legacy as violent, uncivilized, and unworthy of independence.