bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge of Symptoms, Risk Factors, and Treatment Centers of Stroke among the General Population of Al-Ahsa, Saudi Arabia
Authors: Alhubail Fatimah Muhanna , Al-Mousa Ali Mousa , Albusaad Renad , Alsumaeel Salma , Alabbadi Mohammed S. , Almulhim Maryam A. , Alnaaim Saud 
Published: February 2024

Background:
In Saudi Arabia, stroke is a significant cause of illness and mortality progressively becoming more serious. Studies have indicated that modifiable cardiovascular risk factors are responsible for a significant portion of the burden caused by stroke, which could be targeted through public awareness.

Objective:
We evaluated the level of knowledge about stroke among the general population of the Al-Ahsa, Saudi Arabia. Furthermore, association between stroke level of knowledge and sample characteristics was analyzed.

Methods:
This was a cross-sectional study conducted from February 22, 2023, to March 22, 2023, using a convenience sampling technique. An electronic Google Forms survey was distributed through social media, to reach the maximum number of participants.

Results:
This study included a total of 500 participants from Al-Ahsa, Saudi Arabia. Forty-three percentage of participants were male, while 57% were females. Most participants were of a younger age, where 66.6% were 18–39 years. The most recognized stroke symptom, risk factor, and stroke treatment center were dizziness/vertigo (91%), hypertension (97%), and King Fahad Hospital, respectively. Those with higher education possessed a greater level of stroke-related knowledge than other demographic groupings.

Conclusion:
The general public of Al-Ahsa demonstrated a high level of knowledge about stroke symptoms (82.6%), risk factors (90%), and treatment facilities (80%). However, it was evident that the general public failed to recognize the proper course of action in the event of a stroke.
Comparison of Three Scoring Criteria to Assess Recovery from General Anesthesia in the Postanesthesia Care Unit in the Indian Population
Authors: Aggarwal Shagun , Misquith Julie C R , Rao Sumesh T. , Mahanta Priyanka 
Published: February 2024

Background:
Different discharge criteria are available for shifting patients out from postanesthesia care room following surgery. This study was done to compare the three-scoring system namely traditional time-based criteria, Fast track criteria and modified Aldrete score, in Indian population patients who recover after general anesthesia in postanesthesia care unit (PACU).

Materials and Methods:
Three hundred and seventy-five patients scheduled for general anesthesia were included in this study. Induction of anesthesia was done with intravenous (IV) propofol and maintained with sevoflurane inhalation with oxygen and nitrous oxide. Reversal of residual neuromuscular blockade was done with IV neostigmine and glycopyrrolate. Patients were shifted to PACU following tracheal extubation and recovery was assessed using the traditional time-based criteria, fast track criteria, and modified Aldrete score.

Results:
As per modified Aldrete score, mean time of shift out is 19 min with median of 15 min and standard deviation of 21.7 min. As per fast-track score, mean time of shift out is 187 min with median of 30 min and standard deviation of 243.7 min. As per the time-based criteria, mean time of shift out is 222 min with median of 240 min and standard deviation of 136.8 min. While using modified Aldrete score, majority of patients had a shorter stay in PACU and faster time to shift out as compared to fast-track criteria and traditional time-based criteria.

Conclusion:
Modified Aldrete score when compared to fast-track scoring and time-based criteria shows early recovery and reduces the length of stay in PACU.
Diagnostic Utility of Reticulocyte Hemoglobin Equivalent Parameter in the Evaluation of Microcytic Hypochromic Anemia – Our Experience from Northeast India
Authors: Rao H. R. Sohan , Mirji Sadiya 
Published: February 2024

Background:
Reticulocytes are red blood cell precursors with an average lifespan of 1–2 days. Reticulocyte hemoglobin equivalent (Ret-He) is an early marker of iron deficiency (ID) erythropoiesis and reflects real-time information regarding the synthesis of young erythrocytes in the bone marrow. The objective of this study is to determine the diagnostic utility of Ret-He in patients having microcytic hypochromic anemia in comparison with serum ferritin and iron studies.

Objectives:
The objective of this study is to determine the diagnostic utility of the Ret-He parameter in patients having microcytic hypochromic anemia in comparison with the serum ferritin, iron studies and its role in routine hematological screening for nutritional deficiency anemia like ID.

Design and Settings:
The design involves observational study.

Materials and Methods:
A hospital-based observational study was carried out in a referral hospital. Hematological parameters were processed using Sysmex XN1000 (Sysmex Corporation, Kobe, Japan) analyzer and were compared with Serum iron studies using biochemistry analyzer (VITROS® 250 Chemistry System) from 201 participants who presented with microcytic hypochromic anemia.

Main Outcome and Measures:
Relationship of Ret-He parameter and its diagnostic utility for screening of iron-deficient states.

Sample Size:
The sample size was 201.

Results:
When serum ferritin is taken as “the gold standard” to detect ID, with Ret-He cutoff of 27.15 pg/cell, we found a statistically significant positive correlation between Ret-He and serum ferritin (P < 0.001). We found a sensitivity of 57.37% and specificity of 75.95% with area under the curve of 0.681, positive predictive value of 100%, negative predictive value of 3.8%, and accuracy of 62.19% for Ret-He in detecting ID anemia (IDA). Also found a statistically significant negative correlation between Ret-He and total iron binding capacity (P < 0.001). There was no statistical correlation between Ret-He and serum iron levels in our study.

Conclusions:
The present study suggests Ret-He is one of the better and more reliable hematological parameters indicating ID and, when used along with biochemical parameters like serum ferritin, can give valuable inputs in a better screening and diagnosis of IDA; hence proper treatment is possible.

Limitations:
The multicentric study is required to standardize Ret-He reference values, and follow-up to therapy of the subjects was not done. Additional hemoglobin variant analysis data would have been favorable to the study.
Utility of “Acanthosis Nigricans” and “Skin Tags” as a Screening Tool for Risk of Developing Noncommunicable Diseases: A Cross-sectional Study at a Health Facility in Lucknow (India)
Authors: Dixit Sumeet , Chandra Aditya , Kariwala Peeyush , Sachan Beena , Singh Bhanu Pratap , Pathak Anurag , Singh Arvind K. , Kandpal S. D. 
Published: February 2024

Context:
Over the past three decades, there has been a significant rise in the prevalence of noncommunicable diseases (NCDs) globally, accompanied by a relative decline in communicable diseases.

Aims:
With this background, the research was planned to determine the prevalence of acanthosis nigricans (AN) or skin tags (STs) in the study population and to examine the relationship between the presence of AN and ST with commonly used indicators such as waist-to-height ratio (W/Ht.), Indian Diabetes Risk Score (IDRS), and body mass index for predicting the risk of NCDs.

Settings and Design:
This cross-sectional study was done at a health facility in Lucknow (India).

Methodology:
Consecutive sampling was employed to select 152 apparently healthy adults as the participants. Data collection involved administering a questionnaire and conducting anthropometry using standardized methods. Visual inspection was conducted to identify AN or ST on the common sites.

Statistical Analysis Used:
Data entry was done in Microsoft Office Excel, followed by data analysis using SPSS. To test the association between variables “significance of difference of mean,” Chi-square test, logistic regression analysis, and estimation of Kohen’s kappa were used. A “P” value was considered statistically significant at <0.05 level. The sensitivity and specificity of AN and ST were also estimated in predicting the risk of NCDs.

Results:
The prevalence of AN was 19.08% (95% confidence interval [CI] = 12.76%–25.40%), while the prevalence of STs was 28.29% (95% CI = 21.05%–35.53%). AN showed a sensitivity of 22.4% and specificity of 96.3% with W/Ht. ratio as the standard, and a sensitivity of 26.44% and specificity of 90.77% with IDRS as the standard. ST exhibited a sensitivity of 32.0% and specificity of 88.89% with W/Ht. ratio as the standard, and a sensitivity of 37.93% and specificity of 84.62% with IDRS as the standard.

Conclusion:
AN and ST can be used as simple and time-saving tools in screening protocols for (NCDs). Further research is desirable to validate the findings.
Experience with Colostomy and Colostomy Reversal in Children in Bauchi
Authors: Bwala Kefas John , Wabada Samuel , Aminu Mohammed Umar , Ja’afar Abubakar Bappah , Adamu Sani , Oloko Nasirudeen Lanre 
Published: February 2024

Background:
Colostomy is one of the common surgical procedures performed in pediatric surgical practice. The aim of this study was to retrospectively review our experience with colostomy and closure (reversal) in children.

Patients and Methods:
A retrospective review of the data of all children aged 15 years and below who had colostomy and colostomy closure in the past 5 years.

Results:
Of the 67 children who had colostomy 42 (62.7%) boys and 25 (37.3%) girls, with an age range between 13 months and 8 years. Fifty-six (83.6%) of the children were <2 years. Anorectal malformation 53 (79.1%) was the common indication. Divided colostomy was performed in 62 (92.5%) patients and loop colostomy was performed in 5 (7.5%) patients. All the patients had intraperitoneal colostomy closure. A complication rate of 26.4% was seen. Duration of hospital stay ranged between 4 and 10 days. No mortality was recorded.

Conclusion:
Colostomy reversal is a safe procedure but morbidity may ensure and can easily manage.
Prevalence of Paratuberculosis in Dairy Cattle in Ecuador
Authors: Echeverr Gustavo , Escobar Henry , Changoluisa Darwin , Ron Lenin , Proaño Andrea , Proaño-Pérez Freddy , Zumárraga Martin J. , de Waard Jacobus H. 
Published: February 2024

Background:Mycobacterium aviumsubsp.paratuberculosis(MAP) is the causal agent of paratuberculosis, a chronic infectious contagious disease of the intestinal tract of ruminants that are also associated with Crohn's disease in humans. The existence of paratuberculosis in Ecuador is virtually unknown; hence, the present study was performed to gain insight into the prevalence of this disease.Methods:Three dairy cattle farms in different geographic regions in Ecuador were investigated for the infection with MAP, and 600 blood samples, 200 of each cattle herd, were processed with an indirect enzyme-linked immunosorbent assay. Fecal samples of the seropositive cows were processed for culture on modified Löwenstein–Jensen medium.Results:One hundred and fifty bovines (25%) resulted seropositive and we confirmed with culture the presence of MAP in 4.7% (7/150) of the seropositive cows. Approximately 20% of the fecal samples of seropositive cows yielded nontuberculous mycobacteria (NTM) species includingM. aviumsubsp.avium,a NTM species closely related to MAP.Conclusions:The seroprevalence of paratuberculosis in this first study for Ecuador is high (25%). We discuss a possible interference of NTM species, isolated from fecal samples, with the diagnosis of paratuberculosis. With this report, a baseline study, we confirm for the first time the presence of paratuberculosis in Ecuador, and we provide the necessary information for future studies and control of this disease.
An Overview of Pulmonary Infections Due to Rapidly Growing Mycobacteria in South Asia and Impressions from a Subtropical Region
Authors: Shrivastava Kamal , Kumar Chanchal , Singh Anupriya , Narang Anshika , Giri Astha , Sharma Naresh Kumar , Gupta Shraddha , Chauhan Varsha , Gunasekaran Jayanthi , Balasubramanian Viswesvaran , Chaudhry Anil , Singla Rupak , Prasad Rajendra , Varma-Basil Mandira 
Published: February 2024

Background:
Rapidly growing mycobacteria (RGM) comprise nearly half of the validated species of nontuberculous mycobacteria (NTM) and have been reported to have a higher incidence in Asia as compared to Europe and America. There is limited information on RGM infections from South Asia. Hence, the present study aimed to ascertain the incidence of pulmonary infections due to RGM in Delhi and to review the status of available information on the prevalence of RGM in South Asia, a region endemic for tuberculosis.

Methods:
We analyzed 933 mycobacterial isolates obtained from pulmonary samples in Delhi and performed species identification by polymerase chain reaction (PCR)-restriction analysis (restriction fragment length polymorphism) and line probe assay. Drug susceptibility testing (DST) was performed by broth microdilution method. We also reviewed reports available on pulmonary infections in South Asia, attributed to RGM.

Results:
Of the 933 mycobacterial isolates studied, NTM were identified in 152 (16.3%). Of these, 65/152 (42.8%) were RGM comprising Mycobacterium fortuitum (34/65; 52.3%), Mycobacterium abscessus (25/65; 38.5%), Mycobacterium chelonae (3/65; 4.61%), Mycobacterium mucogenicum (2/65; 3.1%), and Mycobacterium smegmatis (1/65; 1.5%). On applying the American Thoracic Society/Infectious Diseases Society of America guidelines, 11/25 (44%) M. abscessus, 3/3 (100%) M. chelonae, and both isolates of M. mucogenicum were found to be clinically relevant. DST revealed that maximum susceptibility of the RGM was seen to linezolid, clarithromycin, and amikacin.

Conclusions:
Of the RGM isolated in the present study, 16/65 (24.6%) were found to be clinically relevant. Hence, it is important to recognize these organisms as potential pathogens to identify patients with RGM disease to initiate appropriate therapy.
Dominant Marker (Inter-Simple Sequence Repeat-Polymerase Chain Reaction) versus Codominant Marker (RLEP-polymerase Chain Reaction) for Laboratory Diagnosis of Leprosy
Authors: Mohanty Partha Sarathi , Bansal Avi Kumar , Naaz Farah , Patil Shripad A. , Arora Mamta , Singh Manjula 
Published: February 2024

Background:
Leprosy is a contagious disease and was eliminated globally in 2002. Since then, new cases were continuously detected from different parts of the world. Untreated leprosy cases shed millions of bacteria and are the main cause of dissemination of the disease. Currently, leprosy is detected by acid-fast bacilli (AFB) microscopy and has a low sensitivity ranging from 10% to 50%. The correlation between clinical findings and microscopy is unable to provide a conclusive case detection. Thus, in the present study, we compared to molecular methods, namely RLEP-polymerase chain reaction (RLEP-PCR) and inter-simple sequence repeat-PCR (ISSR-PCR) taking AFB microscopy as a gold standard for the detection of leprosy.

Methods:
A total of 168 clinically diagnosed leprosy patients were recruited in this study including 58 multibacillary and 110 paucibacillary patients. Slit-skin smear samples were taken for both microscopy and molecular study. Primers for RLEP-PCR were taken from the previous reports. The primers for ISSR-PCR were designed by screening the whole genome of Mycobacterium leprae TN strain (GenBank accession AL450380) for the presence of simple sequence repeats. One primer (TA)8CA3was synthesized and used for molecular amplification of ISSR-PCR.

Results:
We found that the efficacy of the AFB microscopy was 24.40%, whereas the efficacy of RLEP-PCR and ISSR-PCR was 63.09% and 73.21% (P = 0.000, 0.000, and 0.469), respectively. The area under the curve of receiver operating characteristic curve for the comparison of three diagnostic methods was 0.845. An enhancement of 48.81% in the case detection rate by ISSR-PCR over AFB microscopy and 10.12% over RLEP-PCR was also found. Our study clearly reveals that ISSR-PCR is a better tool for diagnosis of leprosy than AFB microscopy and RLEP-PCR. Interestingly, both the PCR techniques RLEP-PCR and ISSR-PCR are able to detect samples which were negative for AFB microscopy.

Conclusion:
Thus, the demonstration of ISSR-PCR in SSS samples can provide a better sensitive and confirmative tool for early diagnosis of leprosy.
Evaluation of the Intracellular Accumulation of Fluoroquinolones in Mycobacteria by Fluorometric Assays
Authors: Deo Nirmala , Sharma Divakar , Bisht Deepa , Venkatesan Krishnamurthy 
Published: February 2024

Background:
Fluoroquinolones (FQs) are being used as second-line agents in the treatment of tuberculosis caused by multidrug-resistant strains. Ofloxacin (OFX) is being tried as a part of modified multidrug therapy regimens for leprosy. A preliminary study was carried out to evaluate the accumulation of FQs – OFX, levofloxacin (LFX), norfloxacin (NFX), and ciprofloxacin (CIF) in Mycobacterium smegmatis.

Methods:

M. smegmatis were grown in Sauton's medium till log phase, harvested and resuspended in phosphate buffer (0.1 M, pH 7.2, Optical Density (OD) of 0.4–0.5) The suspensions were incubated with OFX, LFX, NFX, and CIF (10 μg/ml) at 37°C. The drugs were estimated in the supernatants using spectrofluorimeteric methods. The experiments were also conducted with the addition of carbonyl cyanide m-chlorophenyl hydrazone (CCCP), a proton motive force inhibitor, at 100 μM, 10 min before and/or immediately after the addition of the drugs.

Results:
The time taken to achieve a Steady State Concentration (SSC) of OFX in M. smegmatis was 3 min and the level of accumulation was 102 ng/mg dry weight of the bacilli; with LFX the time for SSC was 5 min and the level of accumulation was 90 ng/mg; in case of NFX the accumulation to SSC was 87 ng/mg in 3 min. CIF accumulation attained a steady state (SSC level of 79 ng/mg) in 4 min. The accumulation kinetics for NFX in M. smegmatis using the spectrofluorimetric method is comparable with radioactive assays. Dose-related accumulation was observed with 10 μg/ml exposure concentrations. The addition of CCCP failed to influence the accumulation of each of these quinolones.

Conclusion:
The findings of dose-related accumulation of OFX, LFX NFX, and CIF suggest simple diffusion as the possible mechanism of transport of these drugs.
Risk Factors for Hypercalcemia in Patients with Tuberculosis
Authors: John Sujith Mathew , Sagar Sheeba , Aparna Joshi Krishnakumari , Joy Sharon , Mishra Ajay Kumar 
Published: February 2024

Background:Tuberculosis (TB) is prevalent worldwide and causes significant morbidity and mortality. TB is known to cause hypercalcemia. We aimed to assess the prevalence and risk factors for developing hypercalcemia among patients with TB.Methods:In this retrospective case–control study, patients with microbiological evidence of TB and an available serum calcium value were included between 2005 and 2016. The demographic, clinical, and laboratory details were recorded. Various risk factors were compared in TB patients with and without hypercalcemia.Results:A total of 129 patients fulfilled the inclusion criteria. Twenty percent were found to have an elevated serum calcium level, 65% of them had clinical features of hypercalcemia. In comparison, the odds of developing hypercalcemia in the presence of disseminated TB, diabetes and renal failure was 1.83, 1.60, and 7.33, respectively.Conclusion:One-fifth of patients with TB have hypercalcemia. Risk factors of the same are renal failure, diabetes, and disseminated TB.
Evaluation of Mycobacterium kansasii Extracellular Vesicles Role in BALB/c Mice Immune Modulatory
Authors: Tavassol Zahra Hoseini , Aziziraftar Shahrbanoo Keshavarz , Behrouzi Ava , Ghazanfari Morteza , Masoumi Morteza , Fateh Aboulfazl , Vaziri Farzam , Siadat Seyed Davar 
Published: February 2024

Background:

Mycobacterium kansasii as a nontuberculosis mycobacteria, naturally release extracellular vesicles (EVs) with widespread utilities. The aim of the present study was the extraction and biological evaluation of M. kansasii EV and its role in BALB/c mice immune modulatory by considering EVs medical usage specificities.

Method:
Density gradient ultracentrifugation method was used to EVs extraction from standard species of M. kansasii. Biologic validation of EVs has been performed by physicochemical experiments. Immunization has been done by subcutaneous injection to BALB/c mice, then spleen cell isolation and lymphocyte transformation test and eventually ELISA cytokine assays were made for interleukin-10 (IL-10) and interferon-gamma (IFN-γ). IBM SPSS version 22 software (SPSS. Inc., Chicago, IL, USA) was used for the data calculation. The evaluation of variables was conducted using one sample t-test.

Results:
Physicochemical experiment results contribute that extracted EVs have intransitive capability to use in immunization schedule. Finally, ELISA test results showed that EVs induced IL-10 production, but have no effect on IFN-γ.

Conclusions:
In this current study, EVs were prepared in high-quality composition. The results of cytokine assay revealed that the extracted EVs have anti-inflammatory property. Accordingly, this macromolecule can be used as immune modulatory agents to prevent severe immune reactions, especially in lungs disorders.
Outcomes of Pulmonary Mycobacterium abscessus Infection
Authors: Flight William G. , Hough Natasha E. , Chapman Stephen J. 
Published: February 2024

Background:
Treatment of Mycobacterium abscessus pulmonary disease (PD) is challenging with frequent side effects and uncertain rates of success.

Methods:
We performed a retrospective review of all patients at our center with at least one respiratory sample positive for M. abscessus between 2014 and 2019. Electronic health records were reviewed to determine factors associated with M. abscessus infection and clinical outcomes.

Results:
Thirty-seven patients were identified including 24 with cystic fibrosis (CF), 10 with bronchiectasis, two with chronic obstructive PD (COPD), and one with asthma. American Thoracic Society/Infectious Diseases Society of America criteria for nontuberculous mycobacteria PD were met in 21/37 (56.8%) of cases. Evidence of Aspergillus lung disease was noted in 18 (75.0%) CF patients compared with 3 (23.1%) non-CF patients (P = 0.005). Induction therapy for M. abscessus was given to 22/37 (59.5%) patients (18/24 [75%] with CF and 4/13 [30.8%] without CF). Median duration of induction therapy was 6 weeks (range 3–12). Maintenance antibiotic therapy was prescribed to 17/22 (77.3%) of treated patients. Culture conversion was seen in 15/24 (62.5%) of CF patients compared with 3/13 (23.1%) in the non-CF group (P = 0.034). Culture conversion occurred in 10/22 (45.5%) of treated patients compared with 8/15 (53.3%) untreated patients. Three patients (8.1%) died during follow-up: one with CF and two with COPD.

Conclusions:
Culture conversion following isolation of M. abscessus from respiratory samples not only is more common in CF than in patients without CF but also frequently occurs spontaneously in both groups. Targeted treatment for M. abscessus did not clearly impact rates of culture conversion.