bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of laparoscopic versus open repair of perforated peptic ulcers in low-risk patients
Authors: Elshora Ahmed A. , Moussa Gamal I. , Sehsah Tarek M. , Abd-Raboh Osama H. 
Published: October 2023

Background
Peptic ulcer perforation (PPU) represents the main indication for emergent surgical intervention for peptic ulcer disease. The study aimed to assess the efficacy and safety of laparoscopic repair (PPU) in comparison with open repair in low-risk patients.

Methods
A retrospective study was conducted in a tertiary medical institution that included 98 patients diagnosed with PPU in line with the inclusion criteria. An analysis was performed to compare patients who underwent laparoscopic surgery (LS) (n=31) and patients submitted to open surgery (OS) of PPU (n=67). Characterization of LS and OS was achieved in terms of patients’ demographics, Bœy’s score, PULP score, and intraoperative and postoperative data.

Results
The patient’s mean age in the LS and OS groups were 48.8 and 51.1 years, respectively. Most patients in both groups were men (87.1% and 86.5%, respectively). The mean time for resumption of oral intake after surgery was 2.93 ±1.06 (1–7) days in the laparoscopy group compared with 3.79±0.8 (2–7) days in the laparotomy group (P<0.0001). The average length of hospital stay was 5.77± 1.8 (4–13) days in the LS group and 7.22±1.6 (5–12) days in the OS group (P=0.0001). Early complications (<30 days) were found in 12 patients (12.2%); 3 (9.6%) in the LS group and 9 (13.4%) in the OS group (P=0.5).

Conclusion
Repair of PPU by laparoscopy is a better alternative to the open approach regarding reduction of postoperative hospital stay and fast return to daily activity with less postoperative ileus and wound complications.
Factors predict the adequacy of cervical mediastinoscopy in nonsmall cell lung carcinoma lymph node staging and comparison computed tomography and integrated positron emission tomography
Authors: Sherif Abdelhamid F. , Elsharkawy Sherin M. , Ghalwash Mahmoud M. 
Published: October 2023

Background
Standard cervical mediastinoscopy (SCM) has traditionally been considered the reference standard for grading mediastinal involvement in lung cancer. The objective of this research is to evaluate the impact of surgeon experience and patient-related restrictions on the adequacy of mediastinal lymph node (LN) sampling. Additionally, we aim to assess the effectiveness of PET/computed tomography (CT) in comparison to ECM (extended cervical mediastinoscopy), particularly in identifying metastases in the aortopulmonary window (APW) LN.

Methods
This prospective cohort study involved sixty individuals diagnosed with nonsmall cell lung cancer (NSCLC). The participants underwent fine needle transthoracic aspiration biopsy or bronchoscopy and subsequently had ECM performed. All participants underwent various diagnostic procedures, including thoracic CT, posteroanterior chest radiograph, pulmonary function tests, PET/CT, electrocardiography, cranial magnetic resonance imaging, and laboratory investigations.

Results
In terms of our outcomes, we evaluated the specificity, positive predictive value (PPV), sensitivity, negative predictive value (NPV), and accuracy of ECM. The results for ECM were as follows specificity of 100.0%, PPV of 100.0%, sensitivity of 78.3%, NPV of 88.1%, and accuracy of 91.7%. For PET/CT, the results were: a specificity of 90.5%, PPV of 75.0%, sensitivity of 57.1%, NPV of 80.9%, and accuracy of 78.3%.

Conclusion
The ECM procedure is highly beneficial in identifying APW LN metastasis in individuals diagnosed with nonsmall cell lung cancer. It exhibits a favorable NPV and efficiency. Moreover, it can be easily performed by a team with the necessary experience.
Management of concomitant gallbladder and common bile duct stones: one stage versus two stages
Authors: Mohamed Hossam Mahmoud Ibrahim , Elkatieb Abd Elmoniem Mohamed Ismail , Abdallah Ahmed Mohamed Ali , Elrazik Mahmoud Hasab Elnabi Abd 
Published: October 2023

Background
The ideal management plan for patients diagnosed with concomitant cholelithiasis and choledocholithiasis has been a great matter of debate among hepatobiliary surgeons. Some surgeons prefer a single-stage approach (laparoscopic cholecystectomy LC with laparoscopic common bile duct exploration, LCBDE), while others prefer two-stage approaches (preoperative endoscopic stone extraction followed by interval LC). Herein, we compare the outcomes of the previous two approaches in our Egyptian tertiary care setting.

Methods
Sixty-four patients were eligible for our randomized trial and were randomly assigned into two groups: Group A was scheduled for the single-stage approach and Group B was scheduled for the two-stage approach. Periprocedural outcomes, including success rates, were assessed in the two groups.

Results
Failed stone extraction was encountered in three patients in Group B (success rate 90.62%). However, we were able to completely free the CBD in all patients in Group A (100% success). Operative time was significantly prolonged in Group A (173.13 vs. 75.97 min in Group B). However, Group A patients had a shorter hospitalization period compared with Group B (5 vs. 7 days). Bile leakage was more encountered in Group A, while the incidence of pancreatitis was higher in Group B. All patients were conservatively managed with no further intervention.

Conclusion
A higher, but not statistically significant, success rate was reported with the single-stage approach. Despite this, this technique was preferred due to a shorter hospital stay and higher clearance rates reported in our study.
Using qSOFA and SIRS scores in predicting the outcomes of patients with sepsis in Emergency Department of Menoufia University Hospitals
Authors: Lasheen Athar Fekry , Rageh Tarek Mohey , Al-Abassy Mahmoud Magdy , Selima Ahmed Ragab Abdo 
Published: October 2023

Background
Sepsis is a life-threatening illness in which an infection causes widespread inflammation and organ failure. Quick Sequential Organ Failure Assessment (qSOFA) is a screening tool, which was established by the sepsis-3 task force and depends on respiration rate, systolic blood pressure and altered mental state. The SIRS criteria were too nonspecific to accurately identify cases of systemic inflammation brought on by infection.

Objective
To determine the predictive performance of qSOFA, and SIRS scores for adverse outcomes of patients presenting to the Emergency Department of Menoufia University Hospitals with suspected infection.

Patients and methods
This comparative research was performed in the Emergency Department of Menoufia University Hospital. The study was conducted to 60 patients presented to the resuscitation room of the Emergency Department with infection from April 2022 to November 2022.

Results
There was a statistically significant difference among the examined groups concerning Relation between survival and vital data. There was no statistically significant difference among the examined groups concerning Demographic data (age, sex), comorbidities of the studied patients, Source of infections, cause of sepsis and Outcomes of the studied patients (n=60).

Conclusion
When it came to identifying cases of sepsis, the qSOFA score was both sensitive and predictive. The qSOFA score was very useful in predicting mortality from both the ER and later on in the hospital.
A Comparative study of suture fixed versus nonfixed mesh techniques in laparoscopic trans-abdominal preperitoneal repair of noncomplicated adult inguinal hernia
Authors: Thabet El Ashraf M. , Ali Ahmed M. , Essawy Ayman 
Published: October 2023

Aim
This study aimed at comparing the effect of sutured mesh fixation and non-fixation in cases of laparoscopic trans-abdominal preperitoneal (TAPP) in terms of operative time, hospital stay, and complications particularly recurrence and chronic groin pain (CGP).

Patients and methods
This prospective randomized comparative study included 40 patients diagnosed with noncomplicated inguinal hernias admitted to the Department of Surgery at Fayoum University Hospital, Egypt from March 2019 to July 2021. Cases were divided into two groups by draw of lots; group A as mesh fixation (n=20) and group B as nonfixation (n=20).

Results
The results were calculated with χ
2test (P value). Results were found to be not significant in demographic features, in-hospital stay, hernia characteristics, and complications i.e. (intraoperative, postoperative, and long term) and were significant as regards operative time and early postoperative pain in favor of nonfixation group and results were highly significant (P < 0.001).

Conclusion
TAPP repair without mesh fixation shows advantages over mesh fixation, which include significantly less early postoperative inguinal pain and operative time, with comparable intraoperative, postoperative, and long-term complications (with no increase in hernia recurrence), hospital stay, and mean operative time. Hence, our study favors TAPP without mesh fixation a valuable alternative option.
Choose your own adventure
Authors: Moukaddam Nidal , Tucci Veronica Theresa 
Published: October 2023

Psychiatric advanced directives (PADs) are utilized by mental health patients to direct their psychiatric care including assigning surrogates for medical decision-making, listing preferred inpatient psychiatric/treating facilities, preferred medication regimens to stabilize acute psychiatric condition and to facilitate the patient's overall interaction with the mental health system. This article reviews the rationale behind PADs, how they can be utilized to reduce the need for de-escalation techniques, restraints and chemical anxiolysis by partnering with patients in the delivery of their care. This paper will also briefly address some of the practical limitations that Emergency Physicians and allied health care providers might face in attempting to honor PADs including the inability to admit to preferred facilities due to staff shortages or other issues associated with the global COVID-19 pandemic.

The following core competencies are addressed in this article:
Patient care, Interpersonal and communication skills, and Systems-based practice.
The perception of the medical faculty and undergraduate students regarding online teaching in the era of COVID-19
Authors: Gupta Meeta , Singh Manish , Gupta Rajesh , Sobti Shalini , Gupta Puneeta , Gupta Vanita , Gupta Aditya 
Published: October 2023

Introduction:
In this COVID-19 epidemic, most of the countries are facing issues regarding health care from the points of management, academic, and treatment. Online medical education as an alternate source has been utilized, but it entails certain solutions to the problems encountered in this new methodology of medical education. The study was conducted to enhance the knowledge about the barriers and the concurrent solutions and help improve online medical education in COVID era.

Materials and Methods:
A prospective, cross-sectional study was conducted on 336 undergraduate medical students 61 medical faculty members of ABVMS, Jammu. The two online intake forms in the form of a voluntary, self-administered questionnaires were used to collect the data; whose link was made active from May 15, 2020, to May 30, 2020. The questionnaire was designed with 10 questions for faculty and 7 for students. The questions encompassed different subjects related to their preferences and perception of online learning. The data were entered in MS Excel and analyzed using the SPSS software version 20.0. P <0.05 was considered statistically significant.

Results:
The medical faculty perceived online class discussions and assessments of the students as difficult barriers (27.87% and 40.99%, respectively) and access to books/images for teaching and lectures making and delivering as easy (50.82% and 52.46%, respectively). The students felt that the ease of theoretical learning was best with downloadable AV lectures (54.46%). A total of 48.15% students and 31.15% faculty members supported the use of online education in future (P < 0.0001).

Conclusion:
The coronavirus pandemic appears to be an inflection point that is forcing disruption in how we teach medicine. While in the midst of this COVID-19 crisis, the medical faculty and the students are willing for a favorable change from offline to online medical education in view of an online instructional support/training, and infrastructural change.

The following core competencies are addressed in this article:
Interpersonal and communication skills, Practice-based learning and improvement.
Estimation of the Prevalence of Occupational Exposure to Biological Fluids among Anesthesiologists: A Survey Study
Authors: Sureshan Roopesh , Opneja Sonali , C Jashma , P Joona , D Namratha , Pai Rohini V. , Kambli Deependra , M Riyas 
Published: October 2023

Background and Aims:
Percutaneous injuries caused by sharps and exposure to biological fluids are a serious concern for anesthesiologists and pose a significant risk of transmission of blood-borne pathogens.

Materials and Methods:
The aim of this study was to estimate the prevalence of exposure to biological fluids among anesthesiologists. A questionnaire designed initially was validated after it was sent to 10 anesthesiologists with more than 5 years’ experience. The validated questionnaire was then administered using Google Forms and the link was circulated electronically (e-mail, WhatsApp, and Telegram). This self-administered questionnaire was completed by 100 anesthesiologists. The various types and methods of body fluid years of exposure were also identified.

Results:
The prevalence of occupational exposure to body fluids was 100%. Exposure to either blood or cerebrospinal fluids by sharps was seen in 82%. Majority of the pricks were encountered during recapping of used needles followed by pricks during intravenous cannulation. Body fluid exposure onto the bare skin most frequently encountered was blood, mostly obtained during intravenous cannulation. There were 8% patients who had exposure to human immunodeficiency virus (HIV) and hepatitis B or C patients for which they had taken postexposure prophylaxis.

Conclusion:
Prevalence of exposure to biological fluids among anesthesiologists is alarmingly high. This poses a high risk for transmission of diseases. The use of protective gears and changing our casual attitude can prevent majority of the exposures. The practice of recapping of used needles should be stopped.
Early Doffing among Frontline Healthcare Workers Working in the COVID Areas in Resource-Limited Settings: Lessons Learned and Interventions Taken
Authors: Bhatia Ridhima , Aggarwal Richa , Ravichandrane Banupriya , Rajendrakumar Karthiga , Ahmed Aasim , Sahoo Debasis , Soni Kapil Dev , Khanna Puneet , Trikha Anjan 
Published: October 2023

Background:
In the fight against the pandemic, personal protective equipment (PPE) has played a vital role. However, working with PPE has its own difficulties and problems. The aim of this study was to find out the reasons of early doffing, that is, in doffing in emergency situations before the shift among healthcare workers (HCWs) working in PPE in the COVID areas in resource-limited settings.

Methods:
This cross-sectional, survey-based study was carried out on healthcare workers involved in direct care of patients with COVID-19 in tertiary care COVID center, India. The questionnaire was sent as a Google form through email and social media platforms like WhatsApp and Facebook. The data was reported as the mean ± SD for continuous variables and as the percentage for categorical variables.

Findings:
Among 252 healthcare workers who participated in the survey, 145 (57.5%) participants doffed early on 300 occasions. Out of these 145, 50% doffed early only once and rest doffed early multiple times. The most common reason of early doffing was found to be breach in PPE (15.33%) followed by fogging (14%) and headache (12%), and most commonly, breach was in mask or coverall/gown (32.6% each).

Conclusion:
Although PPE decreases the risk of infection, it is challenging for HCWs to work in PPE leading to instances of early doffing. The most common reason for early doffing in our study was the breach in PPE and the most common component of breach was found to be mask and coverall/gown. Therefore, we suggest that the proper sizes of the PPE should be made available and proper training in donning should be imparted to HCWs working in PPE.
Investigating the challenges faced by denture wearers, such as denture stability, comfort, and esthetics, and their preferences for different types of dentures
Authors: Chavda Ravindra Mandanbhai , Patel Rahulkumar R. , Munia Vipul , Pandya Mahek 
Published: October 2023

ABSTRACT

Background:
Dentures are common prosthetic devices used to replace missing teeth; however, wearers often encounter challenges related to stability, comfort, and esthetics. Understanding these challenges and preferences for different denture types is crucial for improving oral health outcomes and quality of life.

Materials and Methods:
We conducted a comprehensive study involving 500 denture wearers. Participants were assessed for denture stability, comfort, and esthetics using standardized measures. In addition, their preferences for various denture types, including conventional complete dentures, implant-supported overdentures, and partial dentures, were explored through structured interviews.

Results:
In this study, 25% of participants found denture stability to be “very challenging,” 40% considered it “somewhat challenging,” and 35% did not find it challenging. Twenty percent of participants found denture comfort to be “very challenging,” 36% considered it “somewhat challenging,” and 44% did not find it challenging. In the study, 15% of participants found denture esthetics to be “very challenging,” 30% considered it “somewhat challenging,” and 55% did not find it challenging. Thirty percent of participants prefer implant-supported dentures, while 70% do not prefer them.

Conclusions:
Denture wearers commonly experience challenges associated with stability, comfort, and esthetics. Preferences for denture types differ, highlighting the need for personalized treatment options based on individual needs and circumstances.
Pattern of smartphone use, prevalence and correlates of problematic use of smartphone and social media among school going adolescents
Authors: Vaghasiya Shailly , Rajpopat Niyati , Parmar Bharatkumar , Tailor Krishika A. , Patel Hardik V. , Varma Jagdish 
Published: October 2023

ABSTRACT

Background:
Adolescents are likely to quickly adopt newer technologies and face detrimental effects of the same.

Aim:
This study assessed the prevalence and correlates of problematic smartphone and social media use among school-going adolescents.

Methods:
Cross-sectional study was conducted amongst class 8–10 students. Data were collected using an anonymous survey in English which included (a) sociodemographic information, (b) pattern of smartphone use and smartphone addiction scale-short version (SAS-SV), and (c) pattern of social media use and social media disorder (SMD) scale. Educative session on responsible smartphone use was followed by post-session data collection which included patient health questionnaire (PHQ-2), generalized anxiety questionnaire (GAD-2), hyperactivity subscale of strength and difficulty questionnaire (SDQ), and conscientiousness and emotional stability subscales of ten-item personality inventory questionnaire (TIPI) and post-session feedback.

Results:
Three hundred and twenty out of 325 responses were analyzed (180 male and 140 female). About 8% (n = 27) used smartphone for more than four hours. Prevalence of problematic smartphone use was 12.5% and problematic social media use was 11.9%. Problematic smartphone use was associated with duration of smartphone use per day and problematic social media use, which was in turn found to be associated with Facebook use and frequency of Instagram posts. About 80.6% (n = 256) participants agreed that such sessions should be conducted in schools.

Conclusions:
One in ten school going adolescents are likely to be having problematic smartphone and social media use. Awareness sessions in schools about responsible mobile phone use may be an acceptable strategy.
Relapse during opioid use disorder treatment: A pilot study to understand the reasons for opioid use during treatment
Authors: Singh Virendra V. , Dhawan Anju , Sarkar Siddhartha , Mishra Ashwani K. , Chadda Rakesh K. 
Published: October 2023

ABSTRACT

Background:
Opioid use is a cause of concern in many parts of the world. About 2.1% Indians use opioids. Opioids are also the most common drugs used by injection drug users in India. Despite various treatment strategies used to manage opioid use disorders (OUDs), relapse is common. A good treatment program would make efforts to address lapses and prevent relapse. Hence, there is a need to understand the factors associated with relapse in OUD.

Method:
One hundred and twenty patients completed a baseline assessment that included socio-demographic details and the Maudsley Addiction Profile (MAP). They were followed up for three months and assessed using telephonic interview for opioid use. All those who relapsed were assessed using the Reasons for Relapse Questionnaire (RRQ). The patients who relapsed were compared with the patients who were abstinent. Relapse was defined as any use of opioid during follow-up.

Results:
Forty participants relapsed during the 90 days of the study period. Relapsed patients had a greater number of conflict days with family members, used a higher amount of heroin and cannabis at baseline, were less likely to be discharged on buprenorphine, and were more likely to drop out. Participants cited mood and social reasons more often than cue/craving and unwell domains of RRQ.

Conclusion:
Baseline treatment and prospective factors are associated with relapse in OUD. Addressing these factors can help in reducing relapse in OUD patients.