bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reference for normal measurements of psoas muscle among the adult population in Saudi Arabia
Authors: Wazzan Mohammad Abdulrahim 
Published: November 2023

ABSTRACT

Background:
Psoas muscle measurements and values are generally used to diagnose sarcopenia and evaluate health and well-being. These tests can provide valuable and objective methods to assess patient tolerance to treatments including major surgery, chemotherapy, and physiotherapy.

Aim:
In this study, we validated the normal measurements and values of the psoas muscle in the adult population of Saudi Arabia.

Settings and Design:
This study included a retrospective analysis of computerized tomography (CT) studies of 500 adult patients over 18 years of age without any known medical illnesses.

Methods:
The surface areas and volumes of the psoas muscles on both sides were measured separately on each CT scan in squared centimeters and cubic centimeters (cm3), respectively. The normalized total psoas area (NTPA) was calculated as the total (right and left) psoas area in mm2 normalized to the patient height in meters (m).

Statistical Analysis:
All statistical analyses were performed using SPSS version 23.0 software (IBM SPSS, Chicago, IL, USA). The Student’s t-test was used to evaluate measurement differences between males and females. One-way analysis of variance was used to determine measurement differences due to age. P < 0.001 was considered statistically significant.

Results:
The psoas muscle values of male participants were significantly higher than those of females. The volumes, surface areas, and NTPAs of the psoas muscles were correlated with patient age and sex. Muscle mass decreased with age, especially after the fifth decade of life, and the highest measurement was observed in the fourth decade of life. The mean psoas muscle surface areas at the lumbar vertebra 4 (L4) level measured 14.0 ± 3.4 cm2 and 7.5 ± 2.2 cm2 in the male and female populations, respectively. Furthermore, the mean psoas muscle volumes measured 436.0 ± 140.2 cm3 and 219.1 ± 73.1 cm3 in the male and female populations, respectively. Finally, the total NTPAs measured 995.1 ± 302.9 mm2/m2 and 667.0 ± 538.5 mm2/m2 in the male and female populations, respectively.

Conclusion:
This study established psoas muscle reference values suitable for defining sarcopenia in the Saudi Arabian population. Our study results suggest that application of these research methods to determine psoas muscle values may enable assessment of future health-care outcomes for individuals. Moreover, the results may be utilized in a unique and constructive way to predict tolerance of patient populations to therapeutic interventions including surgery, cancer treatment, and rehabilitation services.
Tonsillitis Prevalence, Diagnosis, and Treatment among Patients at Al-Baha Region, Saudi Arabia
Authors: Alghamdi Rawan M. , Alzahrani Rajab Ahmed , Alzahrani Abdullah Ali H. , Alghamdi Fayez Saad , Albanghali Mohammad A. , Mir Shazia Shaheen , Almalki Shaia Saleh Rajab 
Published: November 2023

ABSTRACT

Background:
Tonsillitis is considered one of the most otolaryngological diseases affecting children and adults. Tonsillectomy is one of the common surgical procedures mostly with children and in cases of chronic tonsillitis or recurrent tonsillitis.

Aims:
The objective of this study was to examine the incidence of tonsillitis, along with its methods of diagnosis and treatment, among patients residing in the Al-Baha region of Saudi Arabia.

Settings and Design:
A retrospective observational cross-sectional analysis of tonsillitis patients who attended the pediatric, emergency room, adult surgery, and ear, nose, and throat clinics at a hospital in Al-Baha, Saudi Arabia, from January 2019 to January 2023.

Subjects and Methods:
This research used purposive sampling. Covered examining data acquired and analyzed 348 tonsillitis-related throat swabs and blood samples.

Statistical Analysis Used:
Data were statistically analyzed using the Statistical Package for the Social Sciences software version 20.0 IBM (Armonk, New York, USA).

Results:
A total of 348 patients diagnosed with tonsillitis were examined. Males had tonsillitis more than females (n = 208, 60% and n = 140, 40%, respectively). The most frequent bacteria isolated were Streptococcus pyogenes group A beta-hemolytic, Staphylococcus aureus, methicillin-resistant S. aureus, and Klebsiella pneumoniae (n = 68, 19.5%; n = 24, 6.9%; n = 12, 3.4%; and n = 12, 3.4%, respectively).

Conclusions:
Tonsillitis is an oral and public disease affecting both children and adults in Al-Baha region. The emphasis should be on enhancing the public health system to reduce tonsillitis and its consequences via effective awareness efforts. Hospitals may also be urged to develop unique criteria for tonsillitis swabs in order to reduce contamination and improve diagnosing the etiology of bacterial tonsillitis.
Tuberculosis of the scalp in a 13-year-old child: A common entity at an uncommon location – A rare case report
Authors: Hassan Mohammad Jaseem , Ahmed Saqib , Khalid Saifullah , Akhtar Kafil , Hasan Mahboob 
Published: November 2023

ABSTRACT
Tuberculosis (TB) caused by Mycobacterium tuberculosis manifests as pulmonary and extrapulmonary forms with cutaneous TB being rare and TB of scalp even rarer. We report the case of a 13-year-old girl who was admitted with a 4-week history of painful swelling and ulcer on the scalp and occasional cough. She had a history of falling on the head 6 months ago. On physical examination, the ulcer measured 6 cm in diameter and was tender with a yellowish-white crust. Contrast-enhanced computed tomography of the head showed a well-defined hypodense peripherally enhancing lesion overlying the left parietal bone with the destruction of the underlying bone. A clinical diagnosis of frontal bone osteomyelitis was made. Abscess drainage was done with excision of the lesion which on histopathological examination showed abundant necrosis with few ill defined epithelioid cell granulomas, langhans type of giant cells, and chronic inflammatory infiltrates. Ziehl–Neelsen staining for acid-fast bacilli was negative, whereas molecular testing by GeneXpert Rifampicin Assay was positive for M. tuberculosis. Thus, a diagnosis of tubercular osteomyelitis was made. Our patient was prescribed four drugs antitubercular regimen for 1 year. On follow-up after 6 months, she is doing fine without any signs and symptoms of the disease. TB should always be kept in mind as the differential diagnosis keeping its varied presentation and high prevalence in our country.
Acute promyelocytic leukemia with acute perforating appendicitis: A rare occurrence of medical and surgical emergency
Authors: Momin Majed Abdul Basit , Reddy Gutha Sashidhar , Manivasagan Manisegran , Ingle Abhijeet , Rathore Rahul Dev Singh , Jakkani Ravikant 
Published: November 2023

ABSTRACT
Acute promyelocytic leukemia (APML) is a rare subtype of acute myeloid leukemia characterized by the predominance of atypical promyelocytes. Acute perforating appendicitis with atypical promyelocytic infiltration of the appendix is exceptionally rare. The presence of a dual emergency complicates diagnosis, management, and survival. A 31-year-old female presented to the emergency department with a 2-week history of fever with chills, diffuse abdominal pain, and vomiting, followed by swelling and pain in the left lower limb, loose stools, and generalized weakness. Hematological findings and abdominal imaging showed APML and acute perforative appendicitis, respectively. She had an emergency laparoscopic appendectomy, which revealed atypical promyelocytic infiltration with perforative appendicitis on histological examination. Despite aggressive treatment, she died as a result of APML-related complications such as disseminated intravascular coagulation, hemorrhages, and shock. This case highlighted the importance of using an early multidisciplinary approach to diagnose and treat these fatal emergencies as promptly as possible.
Student nurses’ experiences of their first clinical placement in intensive care unit: A descriptive phenomenology study
Authors: D Costa Maria Pramila , Leccio Bherlyn Joy , Unissa Syeda Syadath , Al-Shezawi Hanaa Abdulaziz 
Published: November 2023

ABSTRACT

Background:
Technical complexity of patient care and the critical environment at the intensive care unit (ICU) provides a favorable setting for acquiring complicated and comprehensive skills among nursing students.

Aims:
The current research aims to explore the nursing students’ experiences of their first clinical placement in the ICU and identify the factors that facilitate or hinder their learning.

Settings and Design:
A study using a qualitative descriptive phenomenological approach was conducted in one of the Oman College of Health Sciences branches.

Materials and Methods:
A purposive sampling technique was used to recruit 12 Year II students enrolled in the Adult Health Nursing practicum course for in-depth face-to-face interviews. The data were collected in July 2020 following approval of the Ethical Review Board.

Statistical Analysis Used:
All the interviews were transcribed verbatim and analyzed using Colaizzi’s descriptive phenomenological method.

Results:
The study results revealed three themes with several subthemes under each. The “experience,” “challenges,” and “the facilitating and hindering factors for learning” were the themes that emerged from the data analysis.

Conclusions:
Overall, students showed unfavorable responses toward the ICU experience. In addition, the unsupportive interaction with ICU staff contributed significantly to the overall impression. Therefore, strategies to enhance communication and interaction with the ICU staff are essential for a positive ICU learning experience, as students rely on the ICU staff for patient-specific information beyond their academic needs. Therefore, curriculum designers must consider these experiences to facilitate a positive experience in future clinical placements.
A model of medical students’ engagement in quality assurance system at educational program level in Saudi Arabia
Authors: Amer Mona Gomah , Mohamed Nader M. , Nemenqani Dalal M. 
Published: November 2023

ABSTRACT

Background:
Active involvement of students as partners in quality processes at the college is promising in ensuring the quality of the medical school and creating a quality culture for a proper accreditation system.

Aim:
The aim of this study was to explore a model of undergraduate medical students’ perception and understanding of quality assurance (QA) in higher education and identify the challenges and empowerment factors for student involvement in Saudi Arabia.

Setting and Design:
For this purpose, students were involved as official members with the quality team at Saudi medical college. They were included in different tasks and initiatives related to QA, including a peer orientation initiative, through which they became responsible for orienting their colleagues regarding the quality principles and accreditation standards.

Methods:
A questionnaire (pre-and post) was used to evaluate the peer orientation initiative. Furthermore, another questionnaire was directed to the quality team of students to evaluate their experience.

Statistical Analysis:
Done using an independent t-test to measure the efficiency of the student’s peer orientation program through comparing pre- and postquestionnaire results.

Results:
A significant increase in knowledge and improved attitude toward quality and accreditation process at the college was detected after attending the peer orientation program. Students of the quality team recognized the importance of their active engagement and found themselves having voices and able to make changes they confirmed that transparency of QA activities and continuous communication with faculty members and program leaders in regular meetings enhance student’s self-perception, impact their future employment skills, and establish a quality culture in Saudi Arabia.

Conclusion:
The experience should be generalized and disseminated to other health profession education programs with similar students’ populations with adequate rewards and resources.
Assessment of plasma D-dimer level for prognosis, disease progression, and survival in solid malignancies
Authors: Kalwaghe Rucha , Ghongade Pravinkumar , Gupta Anupama 
Published: November 2023

ABSTRACT

Background:
D-dimer is a fibrin degradation product (FDP), a small protein fragment present in the blood after a blood clot is degraded by fibrinolysis.

Aim:
To evaluate the association of D-dimer level with prognosis, disease progression and survival of patients in cases of solid malignancies.

Setting and Design:
Analytical cross sectional study conducted from February 2021 to February 2023.

Materials and Methods:
Data regarding 100 solid malignancy cases including their preintervention D-dimer levels and its value at follow up, grading, TNM [Tumor size (T), node (N), and metastases (M)] staging of tumor, disease progression and patient status were recorded.

Statistical Analysis:
Kaplan–Meier curve and Log Rank.

Results:
Amplified D-dimer level was noted in 85% cancer cases. 76.3% of oral cancer, 82% of breast cancer, 100% cases of digestive tract and ovarian cancer were presented with high D-dimer level. D-dimer in T1 + T2 stage was statistically lower than the D-dimer level of T3 + T4 stage. (χ
2 = 5.40, P = 0.002). Comparison of Lymph node in N0 versus N1 + N2 stage (χ
2 = 5.82, P = 0.0001) as well as no metastases stage (Mo) versus M1 stages (χ
2 = 3.02, P = 0.003) of solid malignancies had significant difference in D-dimer level. D-dimer increased significantly and linearly with recurrence and advancement of solid malignancy. Dead patient had higher D-dimer than alive patients (t = 3.75, P = 0.0001). Increased D-dimer was associated with elevated mortality (P = 0.023, odd ratio = 3.73, survival coefficient = 1.31 with standard error = 0.578).

Conclusion:
D-dimer is a promising prognostic biomarker which can predict poor clinical outcomes in cancer patients, cancer recurrence, progression, metastases, poor survival.
Impact of the coronavirus disease 2019 pandemic on neurosurgical patients in Taif city, Saudi Arabia
Authors: Mubaraki Adnan A , Matter Amgad El-Said , Alalawi Rahaf Mansi , Alhulayfi Raghad Mashhour , Al-Towariqi Lamees Khaled , Alghamdi Ghaida Mohammed 
Published: November 2023

ABSTRACT

Background:
During the coronavirus disease 2019 (COVID-19) pandemic, the healthcare systems were obligated to work at more than maximum capacity for time due to the high transmission rate and incidence of newly infected cases. During the pandemic, all priority was given to COVID-19 cases, as the pandemic stream may exceed the health-care system’s available resources, affecting many other patients, including those with neurosurgical disorders.

Aim:
This study was designed to assess how COVID-19 affected neurosurgical patients.

Materials and Methods:
A retrospective study included all patients who were admitted to the neurosurgical department at King Abdulaziz Specialist Hospital, King Faisal Medical Complex, and Al-Hada Armed Forces Hospital during the COVID-19 pandemic. The data were collected in 5 months (April–August 2022) from the records of accessible patients.

Results:
A total of 777 neurosurgical patients were included 474 (61%) patients were male and 303 (39%) were female. The mean age of the patients was 41.2 ± 13.9 years old. A total of 481 (61.9%) patients were admitted before the pandemic, and 120 (15.4%) were admitted during the lockdown, 176 (22.7%) were admitted after the lockdown. The patient’s length of stay ranged from 1 day to more than 1 year, where 307 (39.5%) stayed for 1 week, and only 87 (11.2%) stayed for more than 2 weeks. 338 (70.7%) cases were Priority 1A emergencies, 17.8% improved, 52 (6.7%) remained stationary, while 7 (0.9%) showed clinical deterioration, and 15 (1.9%) died.

Conclusion:
According to the results of this study, both the admission rate for cases and the clinical outcome for neurosurgical patients were adversely affected by the COVID-19 pandemic. Compared to nonurgent cases, urgently admitted cases showed greater improvement.
Comparison of two volumes for extra-amniotic Foley catheter balloon inflation at preinduction of labor cervical ripening in nulliparae
Authors: Ilevbare Fidelis Oziengbe , Iribhogbe Ignis Osehie , Ande Adedapo Babatunde Anibaba , Enaruna Nosakhare Osasere 
Published: November 2023

Background:
The success of induction of labor is dependent on how favorable the cervix is and the unripe cervix thus remains a well-recognized impediment to the successful induction of labor.

Objective:
The objective is to compare the efficacy of 50 ml versus 30 ml fluid inflation of Foley catheter balloon for cervical ripening in postdate nulliparous women billed for induction of labor.

Materials and Methods:
A comparative analytical study with randomization involving 88 nulliparous women with postdated pregnancy requiring cervical ripening prior to induction of labor was carried out from January 1, 2018, to August 31, 2018. They were randomized into Group A consisting of women who had 50 ml (study) and B who received 30 ml (control). Bishop score was assessed 12 h later. Data were entered into a pro forma and analyzed using the IBM Statistical Package 20.

Results:
A total of 88 patients participated in the study. A statistically significant higher mean change in Bishop score was observed in the study group when compared to the control group (5.6 ± 2.5 vs. 3.1 ± 1.6,P= 0.0001), and the difference was statistically significant. Similarly, 41 (93.2%) patients in the study group had a favorable cervix post-ripening, while in the control group, 30 (68.2%) patients had a favorable cervix (P = 0.003). More of the control group had repeat Foley catheter insertion compared to the study group (31.8% vs. 6.8%,P= 0.008).

Conclusion:
The use of 50 ml of fluid to inflate Foley catheter balloon for cervical ripening improves Bishop score better than the smaller volume of 30 ml.
Macrodrip infusion dose error among nurses
Authors: Eleke Chinemerem , Agu Ifeyinwa S. , Ngbala-Okpabi Sabinah , Bempong-Eleke Esther N. 
Published: November 2023

Background:
Infusions must be administered as prescribed as too fast or slow a dose could have deleterious effects.

Objectives:
This study examined the risk for macrodrip infusion dose error among nurses in selected tertiary hospitals in southern Nigeria.

Materials and Methods:
This cross-sectional study was conducted in five university teaching hospitals in 2019. To establish the drop factor of commonly available macrodrip sets, 25 macrodrip sets were randomly sourced from the hospitals' pharmacies. A sample of 291 nurses was selected using proportionate random sampling technique. Data were collected using the adult infusion dose calculation quiz. Collected data were described and analyzed at 5% level of significance.

Results:
About 20 (80%) of the sampled macrodrip sets revealed 20 drops/ml (gtts/ml) drop factor value displayed on the packaging. When measured experimentally, all (100%) of the macrodrip sets delivered exactly 20 gtts/ml. About 255 (87.6%) respondents calculated macrodrip infusion dose while using a wrong drop factor of 10–18 gtts/ml while an additional 12 (4.2%) could not arrive at the expected infusion dose due to formula and arithmetic anomalies. In all, 267 (91.8%) respondents demonstrated tendency for infusion dose calculation error. Nonattendance of training on infusion administration significantly increased the risk for error by 21% (P = 0.001).

Conclusion:
Twenty gtts/ml is the drop factor of common macrodrip sets in southern Nigeria, and nurses were prone to infusing patients at a lower dose than prescribed. Attending training on infusion therapy might remedy this malady.
Assessment of carotid atherosclerosis disease as an incremental predictive value for cardiovascular disease risk
Authors: Laksono Sidhi , Kusharsamita Hillary 
Published: November 2023

Abstract:
Assessment of the carotid atherosclerosis disease can give a prognostication of a patient’s cardiovascular risk. The assessment of carotid atherosclerosis is essential because of the complication of risk factors resulting in severe cardiovascular disease (CVD). This review article aims to summarize systematically the pathophysiology, followed by diagnostic assessment and therapeutic uses of imaging and treatment for carotid atherosclerosis disease. Duplex ultrasound (DUS) of the carotid artery, transcranial Doppler imaging, computed tomographic angiography (CTA), magnetic resonance angiography, and cerebral digital subtraction angiography are diagnostic techniques for carotid stenosis. Currently, DUS of the carotid arteries is the primary screening method for carotid stenosis. Recent interest has focused on carotid intima-media thickness measurements as a possible indicator of early-stage carotid atherosclerosis or CVD risk prediction. Through the growing fields of stress tests and carotid plaque screening, the classification of cardiovascular risk may be improved.
The evidence of chimney grafts in treating aortic arch diseases
Authors: Chen Yanqing , Lu Qingsheng 
Published: November 2023

Abstract:
Steep aortic arch (such as Type III arch) and small angle between the chimney artery and aortic arch are two anatomic conditions suitable for chimney grafts (CGs). The more the number of chimneys, the higher the incidence of endoleak and branch occlusion; thus, the triple-chimney technique should be avoided unless the lesion involves zone 0 and no other better option is available, or a pending rupture is present and requires emergent repair. For the oversize of multiple chimneys, we suggest that the aortic stent and chimney stent should be increased by 5%, respectively, on the basis of single chimney. Moreover, the direction of the chimney stent is decided by the relative position of the proximal tear in patients with dissection. When the tear is located in the anterior segment, the chimney graft should be deployed behind the aortic stent graft, close to the posterior wall of the thoracic aorta, and in front of the aortic stent grafts when the tear is located in the posterior segment. In conclusion, if the endoleak is small and the patient’s condition is stable with no obvious discomfort, for most of the patients, the endoleak will disappear spontaneously in the follow-up. If the endoleak is large, microcoil could be implanted through the narrow and long gap to block the endoleak under the guidance of ultrasound. CGs technique needs to be scrutinized continuously as new data emerge. Special configurations of aortic and chimney endograft need to be developed to better treat aortic pathologies involving supra-arch branches.
A Case of Acute Intestinal Obstruction in an Infant during the COVID-19 Pandemic
Authors: Aihole Jayalaxmi Shripati 
Published: November 2023

Abstract
Anomalous congenital bands are rare causes of intestinal obstruction in children, adults, and neonates. They are rarely reported, and their etiopathogenesis is unknown, without malrotation in children. Their presentation and radiographic features are similar to any acute intestinal obstruction. The author found approximately 50 similar cases in the literature; however, during and after COVID-19 pandemic, this is the first case of anomalous congenital obstructing band without mal rotation to be reported to date. This is a rare case of infantile intestinal obstruction managed during COVID-19 pandemic. Acute intestinal obstruction due to a congenital anomalous band is rare in infants and children, and if not treated promptly, can lead to morbidity and mortality. Various reasons, such as congenital, acquired, and extrinsic or intrinsic pathologies in children and adults, may be the cause for acute intestinal obstruction. Congenital anomalous bands account for 3% of the intestinal obstructions in infants and children. These bands may cause ischemia and gangrene of the bowel without timely intervention.