bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparative Study of Modified Alvarado Scoring and Raja Isteri Pengiran Anak Saleha Appendicitis Scoring Systems for the Diagnosis of Acute Appendicitis
Authors: Siva A. , Abraham Santhosh John , Iype Vimal 
Published: February 2024

Background:
Acute appendicitis is one of the most common surgical emergencies, with a lifetime prevalence rate of approximately one in seven. There have been various scoring systems developed, of which Alvarado and modified Alvarado scores have been used commonly, but both have low diagnostic value when used in Middle Eastern and Asian populations. Different techniques have been devised to assist in equivocal cases in attempts to decrease negative appendicectomy rates. In the present study, Modified Alvarado Scoring System (MASS) and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) are compared amongst the local population in Kerala, to find out which scoring system is more relevant and applicable, in order to aid early diagnosis of acute appendicitis.

Materials and Methods:
This is a prospective study which included 125 patients for a period of 13 months from November 2020 to December 2021.

Results:
The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MASS score were 62.11%, 60.00%, 83.10% and 33.33%, respectively. The sensitivity, specificity, PPV and NPV of RIPASA score were 90.53%, 76.67%, 92.47% and 71.88%, respectively. The diagnostic accuracy of MASS and RIPASA scoring systems was 61.6% and 87.2%, respectively. The results indicate that RIPASA scoring system is a better diagnostic tool for diagnosing acute appendicitis.

Conclusions:
Based on this study, RIPASA scoring system is more accurate and specific than MASS in diagnosing acute appendicitis.
Changing Dynamics of Self-Harm by Attempted Suicidal Hanging during the COVID-19 Pandemic
Authors: Nair Shalini , Selwyn Tryphena , Varghese Mammen P. , Karuppusami Reka , Aaron Sanjith 
Published: February 2024

ABSTRACT

Background:
The second wave of coronavirus disease (COVID-19) in 2021 was devastating for low- and middle-income countries (LMICs). This led to increased suicide rates among the young, economically productive age group. We analyzed the cohort of attempted suicidal hangings needing admission to the intensive care unit (ICU) and compared the data from the pre-COVID-19 era.

Materials and Methods:
We conducted a retrospective, observational, cohort study of suicidal hanging cases according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Six-month data of such cases admitted to the neurological ICU after the lockdown of the second wave of COVID-19 from July 2021 to January 2022 were collected. Demographic data along with the cause of attempted hanging, severity of sickness from hanging, and its outcome were gathered and compared with similar data acquired during 2003–2015 by the same authors in the same ICU.

Results:
There was a threefold increase in the incidence of suicidal hangings needing ICU care, from 9 to 27% in the pre- and post-COVID-19 era. A shift toward older aged males, in the third decade of life, was observed. The common cause of attempted suicide was a familial dispute (P = 0.03). Among the younger age group (18–25 years), increased screen time led to fights in the family. The cohort was also sicker with more severe lung involvement, longer ventilation, and hospital stay (P < 0.001).

Conclusion:
The increased incidence of hanging among young adults, amid the socioeconomic effects of COVID-19, needs urgent attention. Suicide prevention measures need novel strategies aimed at de-addiction from electronic gadgets and reducing screen time.
Does Transcutaneous Electrical Nerve Stimulation (TENS) along with Jacobson’s Progressive Relaxation Technique Influence Dysfunctional Breathing in Individuals with Chronic Neck Pain?
Authors: Deshmukh Mayura P. , Gopiyani Ishani , Baxi Gaurang , Palekar Tushar J. , Pokle Siddhi 
Published: February 2024

ABSTRACT

Background:
Amongst all musculoskeletal problems, chronic neck pain has a high prevalence and impacts an individual’s wellbeing and quality of life. Due to chronic neck pain, many changes occur which can prompt biomechanical changes in the dorsal/thoracic spine and hence on respiratory muscle work. There is a close bidirectional relationship between pain and the autonomic nervous system. Chronic pain bringing about permanent up gradation of the autonomic nervous system prompts modifications in vital parameters, which in turn if persists results in dysfunctional breathing.

Methodology:
30 chronic neck pain people were selected to determine the immediate effect of transcutaneous electrical nerve stimulation and Jacobson’s relaxation technique in individuals with chronic neck pain. Prepost intervention assessment for pain and dysfunctional breathing were compared and analyzed using paired ttest and Wilcoxon rank sum test.

Result:
For pain, the mean difference (−2.23) was statistically significant (P < 0.001) whereas the breath hold test at total lung capacity and functional residual capacity showed mean differences (7.40) and (−6.83), respectively which were both statistically significant (P < 0.001).

Conclusion:
TENS along with Jacobson’s Progressive Relaxation Technique helps to reduce pain and correct dysfunctional breathing in individuals with chronic neck pain.
Effectiveness of PEEP and Recruitment Maneuvers in Improving Oxygenation in Laparoscopic Hysterectomies: A Randomized Controlled Trial
Authors: Gayathri Balasubramaniam , John K Joy , Ramani CK Swetha 
Published: February 2024

ABSTRACT

Rationale:
To determine whether positive end-expiratory pressure (PEEP) with lung recruitment will benefit in improving oxygenation and in reduction of post-operative complications in patients undergoing gynecological laparoscopic surgeries in Trendelenburg position.

Methods:
Seventy-two patients, 36 in each arm, were recruited for single blind randomized controlled trial. Patients in intervention arm received a PEEP of 8 cm H2O and lung recruitment every 45 min and at the end of surgery. Patients in non-intervention arm (group N) received conventional ventilation with no PEEP and recruitment maneuver. Analysis was done on the basis of PaO2, intraoperative hemodynamics, and post-operative complications.

Results:
Intra-operative pH, pO2, and pCO2 values were 7.41 ± 0.03; 193.8 ± 13.4; and 38.6 ± 2.6 mmHg in group P, and 7.39 ± 0.72; 162.1 ± 5.3; and 38.8 ± 2 mmHg in group N. A significant increase in pO2 level was noted in the PEEP with recruitment group. Post-operative pH, pO2, and pCO2 values in group P were 7.33 ± 0.03; 87.5 ± 4; and 37.2 ± 3.1 mmHg, respectively, in group P and 7.32 ± 0.03, 87.8 ± 2.7; and 38.5 ± 2.6 mmHg in group N. No significant difference in the arterial blood gas (ABG) values was noted in both the groups in the post-operative period. We did not notice any significant hemodynamic variation in the intervention group (group P) checked 1 min, 3 min, and 5 after performing after recruitment maneuver (RM).

Conclusion:
PEEP with RM can be used to improve oxygenation in patients undergoing laparoscopic surgeries in Trendelenburg position. It has no effect in improving post-operative oxygenation.
Impact of a New Module to Enhance the Learning of Ethical Principles in Students of Phase I MBBS Course
Authors: Chaudhuri Arunima , Ghosh Tapas , Saldanha Daniel 
Published: February 2024

ABSTRACT

Background:
Healthcare decisions need to be based not only on clinical and technical grounds but also on ethical considerations.

Aims:
To develop a module for teaching ethics to newly admitted medical students and help medical students recognize the importance of being sensitive to ethical issues in daily clinical practice and develop the ability to address the ethical concerns of patients efficiently.

Methodology:
An interactive module was developed and introduced among first-phase MBBS students over a period of 4 weeks after taking institutional ethical clearance and informed consent of the participants.

Results:
Two hundred students of First Phase MBBS batch 2021-2022 participated in the study. Students performed significantly better in the post-test examination (mean ± standard deviation: 89.65 ± 4.9) as compared to the pretest examination (mean ± standard deviation: 49.34 ± 12.02); P value <.0001**. Students and faculty members were satisfied with the teaching-learning methodology implemented. In the one-month period of time, 48 students could complete the Good Clinical Practice course available at https://gcp.nidatraining.org/with more than 80% marks after appearing for 11 examinations and receiving certificates valid for three years.

Conclusions:
The present module on medical ethics introduced among first-phase MBBS students helped them to learn the core principles of ethics in medicine. It increased their critical thinking and problem-solving abilities.
Shelf-Life Evaluation and Comparative High-Performance Thin-Layer Chromatography Profile of Amavatari rasa: A Preliminary Study
Authors: Bhinde Sonam Sagar , Patgiri B. J. 
Published: February 2024

ABSTRACT

Background:
In addition to safety and efficacy data, it is important to establish quality parameters for all drugs, including shelf life. Shelf life is the length of time that a product may be stored without becoming unfit for use, consumption, or sale. Every product in this universe has a definite shelf life. In Ayurveda texts, shelf life is known as Saviryata avadhi that is defined as the time period during which the potency (Virya) of any drug remains unaffected. Amavatari
Rasa (AR) is an important formulation being used in Ayurvedic therapeutics; however, its shelf life is not reported till date.

Aims and Objectives:
This study aimed to evaluate shelf life of AR through accelerated stability study.

Materials and Methods:
Accelerated stability study and comparative high-performance thin-layer chromatography (HPTLC) profile were done to evaluate the shelf life of the AR. The formulation was prepared by using authentic raw material in the departmental laboratory by the following classical guidelines. It was evaluated by analyzing changes in physicochemical profiles of the product after keeping it at specific temperature (40°C ± 2°C) and relative humidity (75% ± 5%). Analysis was carried out at the intervals of 0, 3, and 6 months. Average 10% degradation time was calculated and extrapolated to find the shelf life as per the ICH guidelines.

Results and Conclusion:
In the present study, shelf life of AR was found to be 48 months; similar Rf values obtained in HPTLC analysis of AR initially and after 6 months showed the minimum deterioration of the product.
A Study Comparing the Aerosol Box and Mayo Containment setup During Intubation in COVID-negative Indian Patients as a Learning Curve
Authors: Jayakar Sheetal , Jayakar Sudhir , Brar Tavleen , Kabeer Waseema 
Published: February 2024

ABSTRACT

Objective:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) is highly contagious. The use of other barrier techniques, in addition to personal protective equipment (PPE), to limit aerosolization and protect against contamination may also be helpful.

Design:
This is a prospective, randomized, single-blind, comparative study to compare the efficacy of aerosol box with the Mayo trolley containment setup during intubation.

Materials and Methods:
The two setups were compared for ease and time taken for intubation, restriction of hand movement, difficulty in accessing equipment, difficulty in railroading of endotracheal tube (ETT) over a bougie, and general satisfaction of operator during intubation using the C-MAC video laryngoscope. The mean time taken for endotracheal intubation (ETI) was compared using the unpaired t-test, and the rest of the categorical variables were presented as proportions and percentages.

Results:
The mean time taken for ETI using the Mayo trolley was 42.6 seconds as compared to 54.5 seconds with an aerosol box. The operator was more satisfied with the Mayo trolley setup.

Conclusion:
The Mayo trolley containment setup is an inexpensive and readily available alternative to the aerosol box in any setting, with a lesser time taken to intubation and lesser restriction of hand movement, easy accessibility of equipment, and easy railroading of ETT over a bougie.
Depressive Symptoms among Children with Sickle Cell Anemia in a Tertiary Health Facility in North-western Nigeria
Authors: Jiya Fatima Bello , Jiya Nma Muhammed , Baba Jibrin , Bakare Abdulfatai Tomori , Ibitoye Paul Kehinde , Adamu Asma’u , Isezuo Khadijat Omeneke , Abba Mohammed Hassan 
Published: February 2024

Abstract

Context:
Sickle cell anemia (SCA) being a chronic debilitating condition places affected children at risk of depression.

Aims:
The aim of this study is to determine the prevalence of depressive symptoms in children with SCA, the perceived causes, intervention sought, and associated factors.

Settings and Design:
This was a cross-sectional survey involving children with SCA aged 7–15 years attending pediatric hematology clinic of Usmanu Danfodiyo University Teaching Hospital, Sokoto.

Materials and Methods:
Information on depressive symptoms was obtained using the short mood and feelings questionnaire for children and adolescents.

Statistical Analysis Used:
Data were analyzed using IBM-SPSS version 25.0.

Results:
Respondents consisted of 291 child–caregiver pair with M:F of the children 1.6:1 and mean age of 11.0 ± 2.7 years. Majority [239 (82.1%)] of the caregivers were females with mean age 38.4 ± 7.4 years. Most [217 (74.6%)] of the caregivers were Hausa by tribe, married (269, 92.5%), in a monogamous setting, 159 (58.5%) with 129 (44.3%) of them having low socioeconomic status. One hundred and forty-nine (51.2%) children had depressive symptoms. Requirement for daily drug intake (125, 83.9%), missed school days (119, 79.9%), recurrent illness (115, 77.2%), and stress (114, 76.5%) were the commonest perceived causes. Prayers (138, 94.5%) and use of distraction (100, 68.5%) were the commonest interventions adopted. Child age category (P = 0.002), caregiver’s gender (P < 0.001), family setting (P < 0.001), socioeconomic status (P = 0.008), comorbidity (P = 0.021), frequent painful crises (P = 0.001), and frequent hospital admission (P = 0.024) were associated with depressive symptoms and remained independent predictors of depressive symptoms on logistic regression.

Conclusions:
Depressive symptoms were common among the subjects and associated with some sociodemographic and medical factors.
Accuracy of Saliva as a Diagnostic Medium for Hepatitis B Virus Infection: A Quantitative ELISA Analysis
Authors: Onyia Nonso E. , Okoh Mercy , Omoregie Felix O. , Ugiagbe Rose A. , Ayinbuomwan Ekiye 
Published: February 2024

Abstract

Context:
Diagnosis of hepatitis B virus infection (HBV) has been traditionally serum-based with its attendant risks and invasive procedure. Massive research interests are being directed to the use of saliva for screening, diagnosis, and monitoring of several infectious diseases, including HBV. Various reports suggest that saliva contains biomarkers that are comparable with that of sera. It can also be obtained with minimal risk to the clinician and patient as well.

Aim:
To determine the diagnostic accuracy of saliva in quantitative detection of hepatitis B surface antigen (HBsAg) using enzyme-linked immunosorbent assay (ELISA).

Settings and Design:
This cross-sectional analytical study was performed on HBV seropositive patients at the Gastroenterology clinic of the University of Benin Teaching Hospital, Benin City, Edo State.

Materials and Methods:
Under standardized conditions, equal amounts of blood and saliva samples of 43 HBsAg seropositive patients were analyzed using ELISA to quantitatively detect the concentration of HBsAg.

Statistical Analysis Used:
The analysis relied on Spearman’s correlation coefficient, linear regression analysis, and Bland–Altman plots to describe the correlational, predictive, and agreements between measurements of HBsAg in sera and saliva. The statistical significance was set at P < 0.05, while a 95% confidence level was used to construct intervals.

Results:
All participants had detectable levels of HBsAg in both saliva and serum with mean titers of 1.70 ± 0.35 ng/ml and 2.80 ± 0.77 ng/ml, respectively. Correlational and linear regression showed poor fit and predictive relationships of the HBsAg levels. Bland–Altman analysis showed good agreement and no significant bias in their diagnostic agreements.

Conclusion:
Saliva can be reliably used in screening and diagnosis of HBV infection. There was agreement in their levels independently and within their averages. It may be premature to rely on saliva for quantitative assay of HBsAg in treatment monitoring.
Comparative evaluation of traditional and molecular diagnostic methods for malaria: An analysis of performance
Authors: Chawla Kiran , Khanna Vinay , Ayer V Sukrita , Khanna Ruchee 
Published: February 2024

Purpose:
As we edge closer to the eradication of malaria, several methods for detecting Plasmodium species have been developed, including peripheral blood smear examination (PBS), rapid diagnostic tests (RDTs), serological evaluations, fluorescent microscopy, polymerase chain reactions (PCRs), fluorescent in situ hybridization, and flow cytometry. The suitability of these tools for routine diagnosis requires evaluation, considering both their diagnostic accuracy and cost-effectiveness.

Materials and Methods:
Our study compared four diagnostic techniques for malaria: PBS, quantitative buffy coat (QBC), RDT, and PCR. We used PCR as the benchmark standard and statistically assessed the performance of PBS, QBC, and RDT against PCR in detecting malaria. Adopting a prospective observational approach, we collected blood samples from 117 patients exhibiting the symptoms suggestive of malaria.

Results:
The findings from our study showed that PBS had a positivity rate of 93.4%, with a 95% confidence interval (CI) of 0.881–0.987, indicating reliable results for a similar population. The QBC assay demonstrated an elevated positivity rate of 96.7% with a solid 95% CI of 0.930–1.000. Although the RDT had a slightly lower rate of 92.4%, it still delivered dependable results, presenting a significant 95% CI of 0.868–0.980, ensuring a robust diagnostic performance compared to PCR.

Conclusion:
PCR is a reliable test when the identification of the specific species is inconclusive. Conversely, the commonly used PBS occasionally overlooks positive malaria cases due to the specialized skills needed for accurate reading. The cost-effective RDT is feasible for field operations without the need for expert knowledge. However, it fails to differentiate between old and new infections. Meanwhile, the QBC test, known for its sensitivity and speed, can be consistently employed for malaria diagnosis in a tertiary care settings.
American Martial Culture and Revolutionary Success
Authors: Rabas Nicholas 
Published: February 2024

The purpose of this research paper is to examine how martial culture impacted every aspect of Colonial American society. Through the use of data and examining military historians such as John Shy and Don Higginbotham, it will show that conflict played an integral part in the development of early American and how it eventually led to a cultural rift between the colonists and England. The colonists were in a constant struggle for survival in the frontier, physically, mentally and ideologically. When their greatest adversaries were no longer in the picture, their own government became a blockade in this pursuit to maintain their way of life.
This paper will also examine how this martial culture influenced the leadership of Revolution in their struggle for independence. Using memoirs and letters, as well as biographies to see how these leaders were shaped and how it impacted their strategic planning when facing the greatest military force of their time. It will also examine the lasting influences of these leader’s martial culture on the whole of the new American martial culture. As well as taking a brief look at their post-revolutionary experiences.
Guatemalan Migration to Los Angeles:
Authors: Solares Jonathan 
Published: February 2024

The Guatemalan migration to Los Angeles hides behind a violent thirty-year Civil War that lasted from 1960 to 1996; the violent events started after the USA supported a coup against the Guatemalan president Jacobo Arbenz. The coup marked the beginning of political instability in Guatemala. The instability led to the formation of guerrilla groups seeking to overthrow the military regime; the confrontation by both groups occurred in the highlands of Guatemala, where many of the indigenous villages were decimated, and its populations almost eradicated. As a result, an increased number of indigenous populations started escaping the political violence they faced by guerrilla and military groups and began migrating to Los Angeles. The number of indigenous people arriving in Los Angeles increased dramatically during the 1980s and 1990s; however, these communities continued to face adversities upon arrival in Los Angeles. The indigenous communities had to find ways to maintain their culture alive and settle in Los Angeles. This paper will seek to explore how the civil war in Guatemala led to an increased number of Guatemalans arriving in Los Angeles, focusing on the Mayan Kanjobal community. The paper will also focus on the settlement of the Kanjobales in the West-Lake and Pico-Union region of Southern Los Angeles and the ways their culture was challenged upon arriving at Los Angeles.