bluuebunny/crossref_metadata_2025_split huggingface dataset:
Late presentation of bladder extrophy with fungating mass: A case report
Authors: Medam N Mallikarjunarao , Thomas Appu , Nair Kannan R 
Published: February 2024

Abstract

Introduction:
Exstrophy of the bladder is a rare congenital anomaly usually treated in neonatal or childhood period. Patient presenting for the first time in the adulthood with fungating mass is an extreme rarity.

Case Report:
A 65-year-old man presented with unreconstructed ectopia vesicae with fungating mass and (acute kidney injury (AKI). The patient underwent an incisional biopsy. Histopathology showed mucinous adenocarcinoma with signet ring cells. Positron emission tomography (PET) computed tomography (CT) showed organ-confined primary bladder malignancy. He underwent radical cystectomy with cutaneous ureterostomy with primary closure of abdominal wall defect. Histopathology showed mucinous adenocarcinoma with signet ring cells (T4aN0).

Discussion:
Bladder exstrophy is a rare congenital anomaly, with an estimated incidence of 1 in 50,000 live births. It is more common in males (male:female, 5:1 to 6:1). The malignant potential of the exstrophied bladder mucosa is well known. Approximately 95% are adenocarcinomas and 3%–5% are squamous cell carcinomas. Most of the malignant tumors (60%) are associated with exstrophy of bladder occurring during the fourth and fifth decades of life.

Conclusion:
Awareness about the malignant potential of bladder extrophy and timely correction of the deformity and monitoring perhaps improves the quality of life when a multidisciplinary approach to treatment is adopted. Efforts should be made to pick up and treat such anomalies much earlier.
Cognition and its relationship with differential white cell count among obese undergraduates in Nigeria
Authors: Mukhtar Isyaku Gwarzo , Salama Precious Ishaya 
Published: February 2024

Abstract

Introduction:
Studies have linked obesity with cognitive impairment and low-grade inflammation; however, results have been inconsistent. The aim of this study was to compare global cognitive function and its relationship with indices of obesity and total and differential white blood cell (WBC) counts in obese and normal-weight undergraduates in Kano, Nigeria.

Materials and Methods:
Eighty participants (40 obese and 40 normal weights) were randomly recruited for this case–control descriptive study. Anthropometric indices were measured according to the World Health Organization’s Stepwise protocol; global cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while the WBC count was performed by manual Leishman staining technique. Data were analyzed on statistical package for social science using an independent t-test, Chi-square test of association, Pearson’s correlation, and simple linear regression.

Results:
The mean age of the participants is 24 years, obese a year older (t = -2.2, P = 0.030). There was no significant difference in global cognitive function score (MoCA score) between the obese and normal-weight participants (t = -1.08, P = 0.283). However, 40% of the normal weight and 42% of the obese participants had mild cognitive impairment. Similarly, the two groups did not differ in total and differential WBC count except for %monocyte, which was higher in normal-weight participants (t = 2.22, P = 0.029). None of the anthropometric and WBC indices correlated with the MoCA score; however, %monocyte was negatively correlated with body mass index (BMI) (r = -0.244, P = 0.029), waist circumference (r = -0.216, P = 0.050), hip circumference (r = -0.234, P = 0.037), and wait-to-height ratio (r = -0.245, P = 0.028) among the whole while %lymphocyte was negatively correlated with BMI (r = -0.311, P = 0.050) among obese participants.

Conclusion:
Obesity is not associated with a decline in cognitive function and inflammation in obese and normal-weight undergraduates in Nigeria.
An obstructed inguinal hernia with maldescended testis as content in an adult male: A case report
Authors: Sharma Aditya , Khanna Rahul , Meena Ram Niwas , Mishra Shashi Prakash , Khanna Seema 
Published: February 2024

Abstract
A long-standing direct inguinal hernia may manifest as an acute or subacute intestinal obstruction. An obstructed direct inguinal hernia with testis as content is extremely uncommon, and up to date, no such case has been reported. Direct inguinal hernias are much less common than indirect ones in terms of incarceration and even strangulation.
Obstructed direct inguinal hernias requiring surgery are very rare. Such hernias are exceedingly challenging to diagnose clinically and are diagnosed intraoperatively. According to the literature, individuals with direct inguinal hernias on the left side are more likely to develop such sequelae.
Herein, we report the case of a 26-year-old male who presented with an obstructed inguinal hernia of the left side with the testis as content, taking into consideration the rarity and possible consequences of such hernias.
The role of financial assessment as a part of corporate social responsibility with special reference to philanthropic responsibility of a multispeciality tertiary care hospital
Authors: Chathoth Rehana Mukundan , Singh Sanjeev K , N Ajith Kumar , T V Sathianadan 
Published: February 2024

Abstract

Background:
Corporate social responsibility (CSR), which includes the healthcare industry, has now taken a significant place within commercial practices. Multispecialty tertiary care hospitals, being major healthcare providers in their communities, have a significant role to play in fulfilling their philanthropic responsibilities and giving back to society. One crucial way in which these hospitals can make a positive impact is through the implementation of financial assessment programs.

Objective:
This study focused to investigate the significance and impact of financial assessment as a component of CSR in the context of a multispecialty tertiary care hospital. The research explores the hospital’s philanthropic responsibilities towards providing financial aid and support to patients in need.

Materials and Methods:
The study used a mixed-methods approach, combining qualitative and quantitative data collection methods to gain comprehensive insights. Interviews from 5 departments with beneficiaries (n = 40), surveys, and financial data analysis were used to assess the hospital’s CSR initiatives, focusing on financial assessment programs. Data were analyzed in SPSS version 20.0.

Results:
The philanthropic variables taken into account in the current study were socioeconomic status, help from external sources, ownership factors, income, and liabilities of beneficiaries. These socioeconomic characteristics were examined using the data gathered, and a significant correlation with the discount percentage was found with a P < 0.05.

Conclusion:
The findings concluded that financial assessment programs in the multispeciality tertiary care hospital are playing an effective role in ensuring equitable access to healthcare and fulfilling its philanthropic responsibilities of CSR.
Mysterious right ventricular function detection in isolated left anterior descending disease by speckle tracking imaging
Authors: El-Bahnasy Hamouda A.K.H. 
Published: February 2024

Background and aimEarly detection of impaired right ventricle (RV) would give significant data for management strategy and prognosis in patients with history of cardiac disease. Echocardiography machine is still the first and most widely used cardiac imaging modality in diagnosing heart disease and assessing systolic and diastolic function with high accuracy. The study aimed to assess mysterious RV function in significant isolated left anterior descending (LAD) disease by imaging with speckle tracking, strain, and strain rate.Patients and methodsThe present study was a comparative prospective study included 100 participants, 50 patients with significant LAD disease who were candidates for Percutaneous coronary intervention (PCI) (group I), and 50 persons as a control group (group II). All participants were exposed to full medical history, clinical examination, ECG, conventional echo, tissue Doppler, speckle tracking imaging.ResultsGlobal longitudinal free wall strain was statistically lower in patient than control group (−19.21±4.11 in patient group vs. −23.73±1.53 in control group,P<0.001), and RV peak systolic strain rate was reduced in patient group than control group (−1.47±0.55 vs. −1.87±0.42,P<0.001).ConclusionIn isolated significant LAD disease RV function should be assessed even after opening of LAD by PCI. New echo modality like strain and strain rate are useful echo methods to detect mysterious RV function in patients with significant LAD disease.
A comparative study of the effect of conventional hemodialysis versus hemodiafiltration on the eye
Authors: Abdalmonem Hesham E. , Younos Hosny A. , Elaziz Alsaid Aldosoky Abd , Abdelgbar Ahmed A. , Abdelaziz Ayman 
Published: February 2024

Background and aim
Hemodiafiltration (HDF) seems to be the gold standard concerning dialysis-aided renal replacements. Hemodialysis (HD) and severe renal failure both have visual side effects, including high intraocular pressure, band keratopathy, macular leakage, red eyes, retinal hemorrhage, and optical neuropathy. The purpose of this study is to examine the impact of routine conventional HD versus routine HDF on ocular problems in individuals with chronic kidney disease (CKD).

Patients and methods
This prospective cross-sectional observational study was conducted on 200 patients divided into 100 patients of CKD on regular HD three times weekly (4 h duration) (HD group) and 100 patients of CKD on regular HDF three times weekly (4 h duration) (HDF group). clinical interview, routine laboratory tests, and complete eye examination were done on all participants.

Results
Prior to treatment, there was no significant difference between the HDF and HD categories for either eye’s central foveal thickness, average macular thickness, visual acuity, intraocular pressure, anterior segment, or fundus examination. In addition, no significant difference was observed between both groups after therapy in both eyes.

Conclusion
Regular HDF and HD treatments administered for 6 months each had no negative impact on ocular parameters.
Evolving Fuchs’ uveitis - A diagnostic challenge
Authors: Kawali Ankush , Sriram Radhika , Srinivasan Sanjay , Mahendradas Padmamalini , Shetty Rohit 
Published: February 2024

Purpose:
To study cases of Fuchs’ uveitis (FU) diagnosed as uveitis other than FU at initial visits.

Methods:
A retrospective, observational chart review. Details of clinical presentation, initial diagnosis, treatment details, and follow-up before and after the diagnosis of FU was studied.

Result:
Twenty eyes of 19 patients finally diagnosed with FU. Mean total follow-up was 39 months (range: 3–120 months, median: 30 months) and follow-up after diagnosis of FU was 18 months (range: 0–84 months, median: 11 months). Most of the cases were diagnosed with anterior plus intermediate uveitis at the presentation (n = 8, 42.1%) and received steroid treatment. Keratic precipitates (KPs) typical of FU developed after mean 5.4 months of presentation (range: 1–18 months, median: 2 months). Altered iris pattern was noted after 17 months of presentation (range: 2–70 months, median: 8.5). Vitritis of grades 1–2 was present in all eyes. Overlap of uveitis of other etiology (retinal vasculitis, presumed tubercular intermediate uveitis) was found in three patients. Systemic immune disease (systemic lupus erythematosus, pulmonary sarcoidosis) was present in two patients. No treatment for the ocular inflammation was given after the diagnosis of FU in any patient and no change in the pattern of FU was observed during further follow-up.

Conclusion:
Evolving FU may lead to misdiagnosis and mismanagement. We suggest a conservative approach, withholding steroid treatment, allowing FU to evolve, in otherwise asymptomatic patients with white eye, mild to moderate anterior chamber (AC) and vitreous inflammation, absent posterior synechiae and normal fundus examination or fundus examination suggestive of resolved uveitis.
Changes in confocal microscopy in glaucoma patients after intraocular pressure reduction with medical therapy
Authors: Hirawat Raj S , Aron Neelima , Mahalingam Karthikeyan , Gupta Viney , Angmo Dewang , Dada Tanuj , Titiyal Jeewan S , Sharma Namrata , Sihota Ramanjit 
Published: February 2024

Purpose:
Topical glaucoma medication is the first line of management to reduce intraocular pressure (IOP) in patients with glaucoma. In this study, we intended to compare the ultrastructural findings of the cornea in patients with glaucoma before and after the reduction of the IOP through confocal microscopy.

Methods:
Ten patients (19 eyes) with newly diagnosed glaucoma were recruited from the glaucoma services of our tertiary care center. Demographic parameters were noted, and basic ocular examination, specular microscopy (Topcon SP3000P, Tokyo, Japan), and ultrasonic pachymetry (300 AP, Sonomed Escalon, Stoneham, MA, USA) were performed. In vivo confocal microscopy of corneal sections was performed using the z-ring Confoscan 4.0 (Nidek, Inc., Freemont, CA) at baseline and after 3 months of starting glaucoma medications.

Results:
The mean age of the patients was 53.53 ± 9.34 years. There was a statistically significant reduction (P < 0.0001) of IOP from 30.21 ± 7.42 mmHg (baseline) to 16.42 ± 4.14 mmHg (3 months). The mean central corneal thickness at baseline was 533.42 ± 3.96 µm, and it further decreased to 521.94 ± 42.45 µm at the end of 3 months (P = 0.006). No significant change was noted in the mean epithelial cell density, mean keratocyte density in anterior and posterior stroma, and the mean endothelial cell density and cell area (P >0.5). There was no significant percentage change in these parameters before and after the lowering of the IOP.

Conclusion:
A short-term (3 months) decrease in IOP using topical glaucoma medications caused a significant reduction in corneal thickness but did not have any significant ultrastructural changes in cornea measured using confocal microscopy.
Characterization the corneal transparency profile in SMILE-treated myopic patients with densitometry: A 7-year cohort study
Authors: Yang Dongmei , Chen Zhuoyi , Zhao Wuxiao , Zhao Jing , Zhou Xingtao , Wang Jifang 
Published: February 2024

Purpose:
To investigate 7-year changes in corneal densitometry (CD) and its influencing factors following small incision lenticule extraction (SMILE) for moderate to high myopia.

Methods:
A total of 32 patients (52 eyes) with a mean spherical equivalent (SE) refraction of -6.30 ± 1.30 D who underwent SMILE were recruited for this prospective study. Pre- and postoperative CD and corneal aberrations were measured by an oculus Pentacam system, and patients were followed up to 7 years. The CD evolution over time and its influencing factors were explored.

Results:
No complications were observed after SMILE. There was a significant time effect on postoperative CD (P < 0.05). The CD values at the 0-to-2 and 2-to-6 mm of the anterior layer increased at the first day (P < 0.05) and declined to baselines at 1 year postoperatively; after that, CD values at any zone and any corneal layer presented a decreasing trend over time (all P < 0.05). Multivariate analysis showed that postoperative CD was positively correlated with age and optical zone (OZ), whereas negatively correlated with SE, corrected distance visual acuity (CDVA), and corneal aberrations (higher-order aberrations, Coma0 and Coma90) (all P < 0.05). Generalized estimating equation revealed that age, SE, CDVA, OZ, and Coma0 were the main factors influencing postoperative CD values (all P < 0.05).

Conclusion:
CD manifested a long-term decreasing trend in moderate to high myopia treated with SMILE. Its main influencing factors are age, SE, CDVA, OZ, and Coma0.
Survey and analysis of accessibility, availability, and affordability of topical glaucoma medicines
Authors: Virani Shalini , Rewri Parveen 
Published: February 2024

Purpose:
Affordability and availability of medicines is a growing global challenge for health-care systems. Access to medicines is recognized as an important determinant of treatment adherence. The access to glaucoma medicines and how it affects glaucoma management are not known. The purpose of this study was to determine the availability, affordability, and accessibility of topical intraocular pressure (IOP) -lowering eye drops in Haryana state of northern India using the World Health Organization (WHO)/Health Action International (HAI) methods.

Methods:
A cross-sectional study was done to collect data on prices and availability of glaucoma topical medications in public and private sector pharmacies and retail outlets using the WHO/HAI methodology between October 2021 and January 2022. The availability and affordability of topical glaucoma medicines was determined. Comparison of the local price with international prices was done by calculating the median price ratio (MPR).

Results:
A total of 191 facilities were randomly sampled across 11 (n = 55) urban, 29 (n = 92) semi-urban, and 44 (n = 44) rural places during the study period. The availability of topical medication for glaucoma was low (35.7 ± 22.3) across all sampled sites and all classes of topical glaucoma medications. The median price of topical medication and availability were negatively correlated, Pearson’s coefficient r (18) = -0.44, P 0.05, though the relationship was weak. A lowest paid, unskilled Indian government worker must spend between 15% and 203% of their daily wage to acquire a glaucoma medication.

Conclusion:
The availability and accessibility of topical glaucoma medications was low in this survey.
Harnessing the medical undergraduate human resource for screening of sight-threatening diabetic retinopathy
Authors: Khandelia Hemant , Deora Aarush , Bhattacharyya Arunangshu , Nangla Parnika , Chawla Rohan , Venkatesh Pradeep , Tandon Radhika 
Published: February 2024

Purpose:
To assess whether medical undergraduates can be trained to effectively screen diabetic retinopathy (DR) by statistical comparison with a retina specialist at a tertiary eye care center in India.

Methods:
Three final-year undergraduate medical students, having completed ophthalmology department rotation, received training from a retina specialist for grading DR, following which they were asked to grade a set of 50 fundus photographs centered on the macula with a view of 50° as sight-threatening DR (STDR), diabetic macular edema, and grade of DR. Agreement among the undergraduates and retina specialist was determined with the help of Cohen’s Kappa coefficient.

Results:
Kappa coefficient between undergraduates for detection of STDR ranged from 0.695 to 0.817 and between each student and the retina specialist ranged from 0.663 to 0.712. The sensitivity and specificity for undergraduates’ and retina specialist’s detection of STDR were 93.93%–96.96% and 60%, respectively.

Conclusion:
There was substantial agreement among the undergraduates as well as between the undergraduates and the retina specialist for the detection of STDR. Undergraduates also detected STDR with a high sensitivity. This study outlines the feasibility of training undergraduate students for screening DR.
Genotypic and phenotypic diversity in X-linked retinoschisis: Findings from a South Indian patient cohort
Authors: Chowdhury Susmita , Chermakani Prakash , Baliga Girish , Anjanamurthy Rupa , Sundaresan Periasamy 
Published: February 2024

Purpose:
Retinoschisis is a distinctive condition characterized by intraretinal layer clefts, primarily associated with X-linked recessive inheritance due to RS1 gene mutations. This study aims to uncover the RS1 mutation spectrum in a cohort of 22 X-linked retinoschisis cases from South India and emphasizes the genotypic and phenotypic associations within patients harboring only RS1 mutations.

Methods:
A total of 22 probands were suspected of having X-linked retinoschisis. All study subjects underwent ophthalmic investigations, including assessments of visual acuity, fundus examination, optical coherence tomography (OCT), and electroretinogram (ERG). RS1 gene screening was conducted using Sanger sequencing, and the pathogenicity of the variants was assessed through Sorting Intolerant from Tolerant (SIFT) and PolyPhen-2 in silico tools.

Results:
The study found that the probands had an average visual acuity of 0.79 ± 0.39 log of minimum angle of resolution (logMAR), ranging from 0.17 to 1.77. During fundus examination, the probands exhibited a characteristic spoke wheel-like pattern in the macular region. Furthermore, OCT analysis revealed distinct alterations in the inner retinal microstructure, and ERG results consistently showed a reduction in b-wave amplitude. Eventually, Sanger sequencing results showed hemizygous mutations in the RS1 gene in only 12 probands, including a novel missense mutation in the RS1 gene’s signal sequence.

Conclusion:
This study provides valuable insights into the spectrum of RS1 mutations in X-linked retinoschisis probands from South India. It reveals distinct genotypic–phenotypic associations and highlights the clinical manifestations associated with the disease pathogenesis.
A comparison between the lecture and self-study methods on female students’ awareness and attitudes about text neck syndrome
Authors: Soheili Mahsa , Shakerian Mahnaz , Soleymani Mohammad Reza , Safapour Parsa , Afshar Mina 
Published: February 2024

BACKGROUND:Text Neck Syndrome (TNS) is a common issue in the neck. The emergence of such issues makes it more pressing to offer ergonomic training to prevent their consequences. The present study aimed to compare training through the lecture and Self-Study methods awareness and attitudes about the TNS.MATERIALS AND METHODS:The study was conducted on 94 female high-school students in 2021, and a quasi-experimental methodology was implemented. The participants were randomly divided into a lecture method and a self-study group. A researcher-made questionnaire was utilized for data collection to measure the participants’ attitudes and awareness. The data were analyzed according to descriptive and inferential statistics.RESULT:The findings showed that the mean post-test scores of the participants’ awareness in the lecture method and self-study groups were 8.74 and 5.83, respectively, and a significant increase was observed in the post-test scores of the lecture method group. However, no significant difference was observed between the pre-test and post-test attitude scores of the two groups.CONCLUSION:As training by the use of the lecture method in a webinar format has the characteristics of a traditional and online educational simultaneously, it offers an advantage that can be utilized in educational institutions as a complementary (or even an independent) method. Moreover, the experts in medical informational sciences need to accompany training groups as they are responsible to select and prepare credible content materials for audiences.