bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative study of percutaneous tracheostomy versus standard surgical tracheostomy
Authors: Abo Ghanima Mahmoud M , El Kholy Amira A , El-Lawaty Walaa M , Zamzam Khaled M , Farhat Amgad A 
Published: January 2024

Abstract

Background
The tracheostomy is an oldest invasive procedure done for critically ill patients. Now, it is usually performed for better weaning and less risk of intubation-related complications either surgically intraoperative or percutaneous procedure which is easily performed at the bedside by an intensivist. The aim of this study is to compare between surgical and percutaneous tracheostomy (PT) in critically ill patients with prolonged ventilation who needed tracheostomy.

Methods
This randomized controlled study was done at the respiratory ICU - Chest Department, Operating Room of the Otorhinolaryngology Department at Tanta University Hospitals, and respiratory ICU Air Forces Hospital. 30 critically ill patients with prolonged mechanical ventilation were divided into two groups. Group I (15 patients) underwent surgical tracheostomy (ST) and group II (15 patients) underwent fiberoptic bronchoscopic-guided PT, from August 2020 to December 2021.

Results
30 patients were enrolled in this study. Neck circumference (cm) was significantly higher in surgical group (P = 0.013). Also, the most important is that the duration of procedure is shorter in percutaneous group (P < 0.001). Regarding delayed complications were insignificantly different between both groups except for stomal infection which was higher in surgical group (P = 0.042). Regarding secondary outcomes of the procedure, successful decannulation, permanent tracheostomy, and death due to primary disease were insignificantly different between the studied groups.

Conclusion
Percutaneous tracheostomy is safer, faster, time saving and less complicated than surgical tracheostomy.
Comparison between nasal high-flow oxygen therapy and noninvasive ventilation on the outcome of patients with chronic interstitial lung disease complicated with acute respiratory failure
Authors: Elkheshen Osama Mohamed , El-Shaarawy Dalia Ezzat , El-Baradey Ghada Fouad , Bahr Hoda Mokhtar 
Published: January 2024

Abstract

Background
Interstitial lung disease (ILD) is a wide range of illnesses that damage the lung parenchyma and have varying etiologies, clinical presentations, radiographic patterns, and histological appearances. The common characteristic is the occurrence of inflammatory and fibrous changes. This work aimed to compare the clinical outcome of high-flow nasal oxygen therapy and noninvasive ventilation in patients presenting with acute exacerbation of chronic interstitial lung disease.

Materials and Methods
This prospective, randomized work was performed on 40 individuals with acute exacerbation of ILD. Participants were categorized into two equal groups: Group1 were treated with high-flow nasal oxygen therapy (HFNOT), aged from 27–82 years. Group 2 were treated with noninvasive ventilation (NIV), aged from 40 to 80 years.

Results
A substantial negative association existed among the HACOR score and ROX index as a low HACOR score and a high ROX index is predicting for success and vice versa. Mortality rate and survival are equal in both groups but HFNOT is more comfortable and better tolerated than NIV, and is also expected to maintain a better quality of life because it easily allows food intake and conversations.

Conclusion
HFNOT is considered to be the first noninvasive option as a noninvasive ventilator in individuals with acute exacerbation of ILD after the failure of conventional oxygen therapy with same efficacy, more tolerability, and less complication carrying the same mortality rate in comparison with NIV.
Outcome of pulmonary complications after hematopoietic stem cell transplantation
Authors: Koraa Emad E Abdel-Wahab , Madkour Ashraf M , Fathy Rehab M M , El Razzaz Mostafa K , Abbas Mohamed S , Abdelrazik Marwa I A 
Published: January 2024

Abstract

Background
Over the past three decades, hematopoietic stem cells transplantation (HSCT)has been widely and increasingly used as standard of care for patients with congenital or acquired hematopoietic disorders. Serious systemic complications, especially pulmonary complications (PCs) both infectious and noninfectious, may occur post transplantation and may be fatal.

Objective
To study the incidence, types, chronology, probable risk factors as well as outcome of posttransplantation PCs in a cohort of HSCT patients who were followed-up for one year.

Methods
This is a prospective observational study conducted on 80 HSCT recipients who were followed-up for one year for occurrence of any respiratory symptom. A diagnostic algorithm was then followed to reach etiology of both infectious and noninfectious causes.

Results
Fourteen (17.5%) patients had pulmonary symptoms, 12 (86%) were due to infections and 2 (14%) were due to noninfectious causes (a case of engraftment syndrome and another of pulmonary embolism), 67% of infectious PCs and all of noninfectious PCs occurred within the first 100 days post HSCT, 60% of infectious PCs were mixed, the most common isolated pathogen was Mycoplasma pneumoniae (60%), PCs related mortality was 21%.

Conclusion
Post HSCT PCs are common, constituting an important cause for mortality, highlighting the necessity for appropriate clinical diagnosis and management.
The outcome of early use of high-velocity nasal insufflation in acute respiratory failure complicating coronavirus disease 2019
Authors: Bakkar Lamees M , Hussein K , Sadek Samiaa H , Abdulkareem Ebtsam S 
Published: January 2024

Abstract

Background
High-flow nasal cannula showed success in some coronavirus disease 2019 (COVID-19) patients. High-velocity nasal insufflation (Hi-VNI) is a refined form of high-flow nasal cannula that delivers heated and humidified gas with high velocity through a simple small-bore nasal cannula.

Objective
To assess the impact of early use of Hi-VNI in improving hypoxemia and respiratory distress and its effect on the length of ICU stay in COVID-19 patients presented with acute respiratory failure.

Patients and methods
In total, 30 patients with confirmed COVID-19 presented with respiratory failure admitted to intensive care of COVID-19 zone were recruited to the study from October 2021 to February 2022. They were categorized into two groups: early and late Hi-VNI groups according to whether the shift to Hi-VNI occurred after low-flow nasal cannula or non-rebreathing mask, respectively.

Results
Successful outcome was achieved in 73.3% in early Hi-VNI group versus 53.3% in late Hi-VNI group. Regarding successful outcome, the duration of Hi-VNI and ICU stay was significantly (P <0.001) lower in early Hi-VNI group. Higher inflammatory markers and lymphopenia are predictors of failure.

Conclusion
The early use of Hi-VNI in hypoxemic respiratory failure of COVID-19 achieved better improvement of respiratory distress, oxygenation, and shorter ICU stay.
A Case Report of Ayurveda Management of Ankylosing Spondylitis
Authors: Medidar Asharani 
Published: January 2024

ABSTRACT
Ankylosing spondylitis (AS) is a type of spondyloarthropathy and involves autoimmune pathology mainly affecting joints of the spine and sacroiliac joints and their soft tissues which are adjacent such as tendons and ligaments. A 12-year-old male patient visited Ayurveda Hospital with complaints of back ache with more severity in the low back radiating to bilateral buttocks, knees, and lower limbs. Considering the clinical history, physical examination, and magnetic resonance imaging of the sacroiliac joint, the condition was diagnosed as AS. As the symptoms of the patient in the present case resembled Gambhira Vatarakta, the patient was treated on the lines of Vatarakta Chikitsa. Shodhana (~Purificatory Methods), Shamana (~Oral medications), and Rasayana (~Rejuvenating medicines) were administered. Shodhana Chikitsa included Snigdha Virechana (~Purgation therapy) and Basti Chikitsa (~medicated enema). The patient showed remarkable improvement in symptoms in the present study by the Ayurveda line of management.
Evaluating the Effects of Topical Mud Application in Managing Psoriasis Symptoms-A Case Report
Authors: Balakrishnan Arthi , Muthupandi Pandiaraja , Arumugam Velan , Annamalai Gayathri , Ponnurangam Ramesh , Kuppusamy Maheshkumar 
Published: January 2024

ABSTRACT
Mud is a combination of various organic and inorganic minerals from natural substances, and mud therapy is considered a conservative treatment approach for psoriasis. A 43-year-old female who has well-defined, erythematous, darkened, scaly annular plaques scattered over her scalp, neck, arms, and lower limbs and has been diagnosed with psoriasis came to the outpatient department for yoga and naturopathy management. Mud application was given every day at 10 am and allowed them to stay in sunlight for 20 min/day for 8 weeks. The Psoriasis Area and Severity Index (PASI) was assessed before and after 8 weeks of mud application. After 8 weeks of mud therapy, the PASI score decreased from 13.8 to 4.6. Our findings show that mud therapy has a positive impact on skin lesions for the patients with psoriasis.
Effect of Ayurvedic Polyherbal Compound (Syrup Kasahara Dashemani) in the Management of Vataja Kasa (Acute Cough) in Children – An Open-label Single-arm Clinical Study
Authors: Yadav Neha , Pathak Vijay Kumar , Mahapatra Arun Kumar , Shrikrishna Rajagopala 
Published: January 2024

ABSTRACT

Background:
Cough is one of the most common clinical presentations encountered frequently in the pediatric population and is correlated with Kasa Roga in Ayurveda. Kasa Roga (cough) is distressing to children and hampers their quality of life. Vataja Kasa (acute cough) if left untreated becomes chronic and distressing to both the child and the parents. Various ayurvedic formulations with cough-suppressing effects have been documented in classical texts that are cost-effective; Kasahara Dashemani is one such ayurvedic polyherbal compound mentioned by Acharya Charaka, possessing antitussive properties that are also evidenced by previous studies.

Objectives:
The objective of this study was to assess the efficacy of Syrup Kasahara Dashemani on classical cardinal features of Vataja Kasa (acute cough), cough scores, and hematological parameters.

Materials and Methods:
The present study was an interventional prospective, open-label, single-arm clinical trial in which 30 children between the age group of 5 and 15 years presenting with classical cardinal features of Vataja Kasa (acute cough) were administered with syrup Kasahara Dashemani orally in various age-dependent doses calculated by using Young’s formula, every 6 h for 1-month duration. Assessment criteria included six classical cardinal features of Vataja Kasa, daytime and nighttime cough scores, and hematological investigations.

Results:
On assessing the outcome parameters, significant improvement was observed in all the six classical cardinal features of Vataja Kasa (acute cough), daytime and nighttime cough scores (P < 0.0001), eosinophil count (P < 0.05), absolute eosinophil count (P < 0.05), and erythrocyte sedimentation rate (P < 0.05) in all the study subjects.

Conclusion:
Syrup Kasahara Dashemani can help alleviate Vataja Kasa (acute cough) in the pediatric population.
Quantification of tongue coating using quantitative light-induced fluorescence-digital image analysis and its correlation with visual evaluation
Authors: Shanbhog Raghavendra , Harjai Gunica , Tiwari Saisaumya , Bhojraj Nandlal 
Published: January 2024

ABSTRACT

Background:
The tongue coating is a grayish-white deposit that quickly reflects the state of health or disease of the human body. Quantitative light-induced fluorescence (QLF) is a novel digital imaging system that objectively quantifies tongue coating.

Aims:
The present study aims to evaluate the correlation between the visual assessment of tongue coating and tongue coating by analysis of QLF-digital (QLF-D) images.

Settings and Design:
This was an in vivo explorative study.

Materials and Methods:
Fifty children aged 11–13 years with clinically visible tongue coating were selected for the study. Tongue coating was assessed clinically by the Tongue Coating Index (Shimizu et al., 2007) and digitally by QLF-D Biluminator™ 2, C3 software.

Statistical Analysis:
Data obtained were subjected to statistical analysis using SPSS 23.0 software. Spearman’s rho correlation test was done, and P < 0.05 was considered statistically significant.

Results:
A statistically significant correlation was found between the visual assessment scoring and the QLF image analysis for the evaluation of tongue coating.

Conclusion:
The Digital QLF tongue imaging system was found to be reliable due to its correlation with the clinical score and objective nature.
A Rare Case of Thymic Carcinoma: Unusual Presentation of Multiple Lymph Node Metastases Masquerading as Lymphoproliferative Disorder
Authors: Raghavan Vijayashree , Srinivasan Sudha , Kanna N. R. Rajesh , Chandrasekaran Kundhavai , Isaac Jane Betsy 
Published: January 2024

Abstract
Thymic carcinoma is known for its aggressive nature and low survival rates. Due to the rarity of its presentation, particularly with multiple lymph node metastasis resembling lymphoproliferative disorders, emphasizes the need to share our case in the literature. We aimed to raise awareness among surgeons regarding this atypical presentation. Our findings indicate that, in cases of higher stage thymic carcinoma, lymph node dissection should be considered in addition to thymectomy. This recommendation is based on our research and can help guide treatment decisions for similar cases in the future.
COVID-19-related Obsessions and Compulsions after the Full Control of the Pandemic: A Sample of the Nonpsychiatric Saudi Young Adults
Authors: Aljwiser Sultan Mohammed , Alqarni Maram Habas , Alanazi Maha Mohammed , Algarni Maram Ali , Alrashed Nujoud Mohammad , Almashoug Madhawi Ali , Alenzi Ebtihag O. , Alateeq Deemah Ateeq 
Published: January 2024

Abstract

Background:
Symptoms of obsessive-compulsive disorder (OCD), contamination type has increased due to the COVID-19 pandemic. However, whether these symptoms would decrease after introducing the vaccines is unknown. Thus, this study examined the prevalence of COVID-19-related OCD among young adults who had never been diagnosed with a psychiatric disorder after fully controlling the pandemic.

Methods:
A sample of 351 young adults from all Saudi regions, whose ages ranged from 18-year-old to 25-year-old, were collected virtually in March and April 2022, via using an Arabic online survey that was distributed through social networks which included socio-demographic characteristics, COVID-19-related items, and COVID-19-related obsessions and compulsions assessment items.

Results:
Most of the participants were females (83.2%), had received the 3rd dose of the vaccine (69.80%), and reported having no obsessive thoughts or compulsive behaviors related to COVID-19 (91.5%, 96.6%). Despite this, males still had lower scores of OCD symptoms related to COVID-19 compared to females (9.98 vs. 14.29). The results also show that the mean scores of OCD symptoms decreased with each vaccine shot, 16.80 ± 18.91, 14.12 ± 10.85, and 13.27 ± 11.27 for the 1st, 2nd, and 3rd doses, respectively.

Conclusion:
Introducing the COVID-19 vaccine may reduce the onsets of obsessions and compulsive behaviors related to contamination. Some compulsive behaviors might be considered the new normal as they do not cause functional impairment.
Application of Aviation Risk Management Policy in Medical Error Cases at King Khalid University Hospital
Authors: Alsubaie Nawaf Mohammed , Alsaleh Faisal Abdulaziz , Alhazzani Hassan Mohammed , Almuhanna Abdulaziz Omar , Alzahrani Mohammed Saeed , Alruwaily Bader Hassan , Hersi Ahmad S. , Kashour Tarek S. 
Published: January 2024

Abstract

Objectives:
Cognitive errors are believed to be responsible for the majority of medical errors in clinical practice. We set to identify the prevalence and the types of cognitive errors among cases reviewed by the Morbidity and Mortality (M and M) Committee at King Khalid University Hospital (KKUH).

Methods:
A cross-sectional, descriptive study conducted at KKUH, in Riyadh, Saudi Arabia from January 2017 to December 2019. All consecutive cases of adult patients that have had a full review by the M and M committee were included. We applied the adapted (aviation risk management criteria to medicine) to detect any cognitive error among our cases. The cases were classified into three classes based on the number of present errors (A; 3 or more errors, B; 2 errors, and C; 1 error). Descriptive statistics (frequencies and percentages) were used to describe the categorical study variables.

Results:
A total of 16 cases were included in this analysis. Eight cases (50%) fulfilled the criteria for category “A” (3 or more cognitive errors). Cases categorized as “B” with 2 errors was seen in 43.8% and cases categorized as “C” with 1 error was seen in 6.2% of cases. The most commonly observed errors were diagnostic flaws such as diagnostic errors in the face of patients’ symptoms.

Conclusion:
We used the aviation risk management approach to identify cognitive errors in medical cases. We observed that ≥3 errors were more prevalent in the reviewed cases, and the majority of these errors were due to diagnostic flaws.
Compared with Their Childhood Baselines, Adolescents with Attention-deficit Hyperactivity Disorder Have Higher Prevalence Rate of Disordered Eating
Authors: Alsindi Aysha Mohammed , Alhamad Noor Mohamed , Alaqili Ameena Khaled , Alfaw Amina Ali , Alabassi Noof Khaled , Ghazzawi Hadeel Ali , Jahrami Haitham 
Published: January 2024

Abstract

Introduction:
Attention-deficit hyperactivity disorder (ADHD) and eating disorders (ED) can coexist. The goal of the current study is to establish if the risk of EDs among participants with ADHD changes as they age.

Materials and Methods:
A longitudinal follow-up study was designed to determine variables of interest to participants during childhood and adolescence. Data were collected at baseline in 2019 (T1) and later in 2023 (T2). Data collection included demographics, anthropometrics, and risk of ED using a validated tool, which is the eating attitudes test-26 (EAT-26).

Results:
The mean age of participants was 13 years at baseline, and 13% were female. About 41% were on methylphenidate as a psychostimulant during T1, and this was reduced to 23%, P < 0.001, effect size (ES) = 0.5. The risk for ED was 29.51% at T1, with a mean EAT-26 score of 15 ± 7. The risk for ED was 36% at T2 with a mean EAT-26 score of 17 ± 6.

Conclusions:
Adolescents with ADHD had a greater prevalence rate of EDs when compared to their childhood baselines. Screening and intervention are therefore essential to reduce the risk of long-term disordered eating in this population.
Unmasking the “Great Masquerader:” Tuberculosis of the Foot
Authors: Sinha Abhinav , Aier Sashitemjen , Samant Asim , Kumar Prem , Kalra Mukesh , Jha Manisha 
Published: January 2024

Abstract

Introduction:
Osteoarticular tuberculosis (TB) accounts for only 1%–3% of extrapulmonary TB, of which ankle and foot involvement accounts for only 8%–10%. Foot and ankle TB has a varied clinical and radiological presentation and can mimic many conditions. The aim of this study is to throw light on the varied clinical and radiological presentations of this disease.

Materials and Methods:
We studied 20 patients with suspected osteoarticular TB of the ankle and foot region over 3 years. The patients were evaluated based on clinical presentation, radiology, magnetic resonance imaging (MRI) findings, molecular studies (cartridge-based nucleic acid amplification test [CBNAAT]), biopsy, microbiological staining and culture, erythrocyte sedimentation rate ESR, and C-reactive protein levels. The patients were categorized into subgroups in accordance with their findings.

Results:
All cases had some form of pain, swelling, tenderness, or inability to bear weight. Twenty-five percent presented with single or multiple draining sinuses at or around the ankle. On X-rays, 30% had unremarkable radiographs, and osteopenia/cavitation of one or more bones was found in 30% of cases. Sequestrum formation was seen in 20% of the cases. No advanced arthritis and collapse were noted. In MRI, all cases had marrow edema of one or more bones. Twenty percent had features of tenosynovitis. CBNAAT was done for all the patients of whom eight turned positive for the pathogen.

Discussion:
The classical features of skeletal TB may elusive in cases of TB of the foot and ankle. Plain radiographs may not be sensitive in detecting early cases. In MRI studies, the calcaneum and talus were mostly affected. This may indicate toward a hypothesis that the calcaneum/talus may be the primary source of origin in osteoarticular TB of the ankle and foot region. Biopsy remains the gold standard in diagnosing TB. All patients responded well to the medical management. We can conclude with surety that TB of the foot and ankle is primarily a medical condition if prompt and early diagnosis is made.
Limb Loss: Facts and Statistics – Diabetes Mellitus and Vascular Insufficiency, a Real Harbinger of Major Limb Amputations – A Cross-sectional Study among Amputees Reporting to a Tertiary Care Center
Authors: Raina Sukhil , Bhat Shriya , Raina Rohit , Bhalla Jatin , Chaudhari Ashish 
Published: January 2024

AbstractBackground:Limb loss to amputation is a major problem, especially in developing countries where the majority of the cases are preventable. It is a burden, not just for the patient but also for their caregivers. Today, when amputation is necessary, surgery is undertaken with consideration for the functional aspects of the residual limb. The purpose of this study was to describe the etiology and characteristics of major limb amputees at a tertiary care center in North India.Methods:This prospective observational study was conducted by the Government Medical College Jammu, for 2 years. Eighty-one patients underwent major limb amputations in our hospital during the study. In this study, we studied several variables including age, sex, side of the limb, level of the amputation, and etiology.Results:In this study, dysvascular disease was the major reason of amputation, diabetes mellitus being the most common cause (39.5%), followed by trauma, with a male preponderance, with peaking at the age of 51–70 years. Lower limb is the most common with the predominance of transtibial amputation. Younger individuals who underwent amputation were mostly due to the trauma. The most common postoperative complication was surgical site infection (21%) and the most common organism cultured from the wound wasPseudomonas(50%). The most common additional procedure done was wound debridement. The mortality rate was 10% and the mean duration of hospital stay was 23 days.Conclusion:In contrast to declining rates of trauma-related and cancer-related amputations, we found evidence of a significant increase in the incidence of amputations due to diabetic foot syndrome. Overall, the risk of amputations increased with age. This was true for all etiologies and for both sexes. Males with an average age of 50 years are generally at higher risk for limb loss than women.