bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low back pain and motor control dysfunction after pregnancy
Authors: Tuominen Reetta , Jahkola Tiina , Mikkonen Jani , Luomajoki Hannu , Arokoski Jari , Vironen Jaana 
Published: August 2023

Purpose:
Pregnancy-related low back pain is a common condition. Persistent postpartum diastasis recti may cause back pain and motor control dysfunction. The role of diastasis in pregnancy-related back pain remains debatable. This study aimed to compare participants with increased symptoms after index pregnancy with those reporting no change in back pain or subjective movement control and to analyze inter-rectus distance.

Materials and Methods:
This case-control study included a cohort of women who delivered 1 year earlier. We recruited participants with increased symptoms (n = 14) after index pregnancy and controls (n = 41) and recorded their inter-rectus distance using ultrasound. A questionnaire was completed, and an ultrasound performed twice for each study group.

Results:
At the baseline, there was no significant difference in inter-rectus distance between cases and controls (mean 2.45 ± 1.01 cm and 2.09 ± 1.03 cm, respectively). A year after index pregnancy symptomatic cases had significantly wider inter-rectus distance than controls (mean 3.45 ± 0.90 cm and 2.40 ± 0.79 cm, respectively). Motor control dysfunction test results were not associated with core stability problems or back pain in this cohort. There was a difference in the sit-up test between cases and controls (mean 4.7 ± 4.2 and 8.2 ± 3.9, respectively).

Conclusion:
Women who reported increased back pain and core instability after index pregnancy had wider inter-rectus diameter than controls. In the case group with more symptoms after pregnancy, the classification of rectus diastasis (RD) changed from mild abdominal RD (2–3 cm) to moderate (>3–5 cm). RD may contribute to persistent pregnancy-related lumbopelvic pain.
Surgical repair of abdominal wall hernias in rural southeast Nigeria
Authors: Ogbuanya Aloysius Ugwu-Olisa , Ugwu Nonyelum Benedette 
Published: August 2023

Background:
Abdominal wall hernias constitute a significant cause of morbidity and mortality globally, but more importantly, they present a more pathetic situation in rural areas of sub-Saharan Africa and other developing nations. In our setting, the rate of elective repair is still too low and many cases present late, often with complications. This study aimed at documenting the spectrum, barriers to early repair, and factors that influence the outcomes of repair.

Materials and Methods:
A prospective study of adult patients surgically treated for abdominal wall hernia in rural southeast Nigeria between January 2014 and December 2019.

Results:
Overall, 975 patients were recruited: 706 (72.4%) had simple uncomplicated hernias, whereas the rest (269, 27.6%) presented in the emergency. Inguinal hernias comprised 74.1% of the cases followed by primary midline hernias (14.5%). Delayed presentation was common, with only 2.3% presenting within three months and the main reason being financial constraint (31.0%) followed by ignorance (12.2%). A third (324, 33.2%) of the patients harbored complete inguinoscrotal/inguinolabial hernias. Nearly a quarter (240, 24.6%) had comorbid illnesses, 14.9% harbored recurrent hernias, and more than a third (43.4%) had hernias with defect sizes >5 cm. Wound infection rates were 34.6% in the emergency group, 26.2% in the elderly, 20.7% for those with recurrent hernias, and 17.1% in those with comorbidities. Morbidity rates were greater in patients with hernia defects >10 cm (37.8%), inguinoscrotal/inguinolabial hernias (18.5%), and those who received bowel resection (56.7%). Generally, elevated wound infection and high overall morbidity rates were associated with emergency presentation (P = 0.000), advancing age (P = 0.030), procedures performed by a nonspecialist surgeon (P = 0.014), and large hernia variants (P = 0.000). Overall, mortality rate was 2.9%, but it was 9.7% in those with emergency repair. The main independent predictors of mortality were intestinal resection (P = 0.000), delayed presentation (0.003), advanced age (0.020), and comorbidities (P = 0.002).

Conclusion:
Delayed presentation, often in an emergency setup, is common among patients with abdominal wall hernias in our rural practice. Financial impediments and ignorance were the main barriers to early presentation and elective repair. Consequently, morbidity and mortality rates were high, especially in the setting of advancing age, delayed presentation, coexisting medical conditions, and bowel resection.
To compare the outcome of inguinal hernia repair under local and spinal anesthesia
Authors: Maurya Naveen K. , Asif Shadab , Tahir Saleem , Aishwarya Kumar , Shiromani Swarnlata 
Published: August 2023

INTRODUCTION:
The most frequent form of hernia is inguinal hernia, affecting around 15% of adult males. The optimal surgical anesthetic method for ambulatory inguinal hernia repair is unknown at the moment, and there is no consensus on the procedure. The goal of this study was to examine the outcome of inguinal hernia repair under local anesthesia compared with spinal anesthesia.

MATERIALS AND METHODS:
In this prospective observational study, 80 patients were randomly assigned into two groups by the SNOSE method with a different mode of anesthesia: group SA (n = 40) and group LA (n = 40). Lichtenstein tension-free hernioplasty was done in all patients. Pre- and post-OP clinical examinations (3rd day) were looked for complications.

RESULTS:
There were no significant demographic differences between the two groups. When compared with the SA group, the LA group experienced much less post-operative pain. With local anesthesia, post-operative ambulation was substantially faster. The use of a local anesthetic allowed for a shorter stay in the hospital and a speedy return to regular activity. In general, local anesthesia was linked to less post-operative complications in the early aftermath.

CONCLUSION:
Local anesthesia is a preferable choice to spinal anesthesia for short stay or daycare surgery, particularly for patients who are unable to tolerate spinal anesthesia. As a result, Lichtenstein’s hernioplasty performed under local anesthesia is attracting considerable interests in the field of groin hernia repair.
A single surgeon's experience of 1000 consecutive transabdominal preperitoneal repair cases and measures to prevent recurrence
Authors: Tazaki Tatsuya , Sasaki Masaru , Kohyama Mohei , Sugiyama Yoichi , Yamaguchi Takuro , Takahashi Shinya , Nakamitsu Atsushi 
Published: August 2023

PURPOSE:
In laparoscopic transabdominal preperitoneal repair (TAPP), the use of a larger mesh has been shown to reduce the rate of recurrence of hernia. However, recurrence may still be observed occasionally, especially in procedures performed by inexperienced surgeons. The purpose of this study was to clarify the learning curve of TAPP and to establish a procedure that precluded the possibility of recurrence.

MATERIALS AND METHODS:
We analyzed the learning curve based on operative time, recurrence, and complication in a single surgeon's experience of 1,000 consecutive TAPP. In addition, by examining cases showing recurrence, techniques necessary to prevent recurrence were clarified.

RESULTS:
The operative time stabilized after 60 cases and continued to reduce thereafter. Recurrence of nine hernias in eight patients within 1 year of surgery was observed up to the 482nd case. Recurrence or intraoperative complication was not confirmed since then. Recurrence after primary inguinal hernia repair presented as indirect hernia-type recurrence. The causes of recurrence were incomplete parietalization in indirect sliding hernia, insufficient dissection of the lateral dorsal side, and up-rolling mesh placement with the lateral dorsal side.

CONCLUSION:
Recurrence can be prevented by sufficiently dissecting the preperitoneal space on the lateral dorsal side and taking care to avoid up-rolling of the mesh while it is being placed.
Feasibility of robotic repair of parastomal hernias
Authors: Schmitt Kyle M. , Albaugh Vance L. , LeBlanc Karl 
Published: August 2023

BACKGROUND:
Parastomal hernias present a common complex surgical problem that has a severe clinical impact on quality of life. Several techniques for repair have been described with open or minimally invasive techniques, although recurrence and reoperation continue to be common problems. In the following, a case series utilizing a technique for a minimally invasive repair using the Di Vinci robotic platform for a mesh-reinforced, modified Sugarbaker repair is described.

STUDY DESIGN:
This study is a retrospective review of 24 cases of robotic-assisted parastomal hernia repairs performed by a single surgeon from 2014 to 2020. Primary endpoints of interest were operative times and length of stay, as well as postoperative complications.

RESULTS:
Twenty-four patients were included in the study. The average operative time was 194.8 min (range: 95–378 min) and the average console time was 149.5 min (range: 72–319 min). The average length of stay was 3.9 days. No patients required conversion to either a laparoscopic or an open procedure, although two complications required reoperation. Twelve patients developed minor complications, including four who developed a postoperative seroma, but none of them required surgical intervention.

CONCLUSIONS:
This is the first and largest series describing a technique for a robotic-assisted parastomal hernia repair. This shows that this procedure can be reliably undertaken with the robotic platform with consistent and reproducible results and few complications. Further long-term research will be needed as new robotic techniques evolve and patients will need follow-up regarding recurrence rates and any late complications evaluated.
Upfront debulking surgery or delayed surgery after neoadjuvant chemotherapy for advanced-stage epithelial ovarian cancer: Comparison of survival from a noncancer center in India
Authors: Shekhar Shashank , Singh Pratibha , Vishnoi Jeewan R , Goel Shuchita , Pareek Puneet , Sharma Charu , Goyal Manu , Yadav Garima , Jhirwal Manisha , Soni Sweta , Misra Sanjeev 
Published: August 2023

Abstract

Background:
In advanced-stage epithelial ovarian cancer (EOC) standard of care is upfront debulking surgery (UDS) followed by adjuvant chemotherapy. Interval debulking surgery after neoadjuvant chemotherapy (NACT-IDS) is a reasonable alternative.

Methods:
This study was a retrospective review of patients of Stage III/IV EOC treated either by UDS or NACT-IDS between January 2016 and December 2018 to report the comparison of progression-free survival (PFS) and overall survival (OS) of patients with advanced-stage EOC treated with either UDS or NACT-IDS.

Results:
Out of 50 patients, 19 (38%) underwent UDS, and 31 (62%) received NACT. The mean follow-up duration was 27.7 months. No gross residual disease was achieved in 52.6% of the UDS group and in 70.4% of the NACT-IDS group. The median PFS of 20 and 30 months was observed in the UDS and NACT-IDS groups, respectively (log-rank P = 0.054). The median OS was 36 months in the NACT-IDS group and could not be reached in the UDS group (log-rank P = 0.329). Only residual disease was significantly associated with survival (hazards ratio 3.03, 95% confidence interval: 1.19–7.74) on multivariate Cox regression analysis.

Conclusions:
In advanced-stage EOC, the survival outcomes of NACT-IDS are comparable with those of UDS. Apart from the patient-specific parameters, the decision for UDS or NACT-IDS should take in account the expertise of the surgeon and the institutional capacity as a whole.
Clinical presentation and outcomes of pediatric anaplastic large cell lymphoma: A tertiary center experience from India
Authors: Sahoo Debasish , Gupta Aditya Kumar , Wajid M Abdul , Meena Jagdish Prasad , Seth Rachna 
Published: August 2023

Abstract

Background:
Anaplastic large cell lymphoma (ALCL) is an uncommon T-cell lymphoma, accounting for 10–15% of pediatric non-Hodgkin lymphoma (NHL). Outcomes of ALCL have not improved in recent years despite better chemotherapy and supportive care. This study aimed to analyze the clinical profile and outcomes of pediatric ALCL patients at our center.

Materials and Methods:
Medical records of children with ALCL from July 2017 to December 2019 were reviewed. Their clinical and laboratory details were noted. The outcomes of all patients were recorded.

Results:
Ten patients were diagnosed with ALCL during this period. The median age at diagnosis was 8 years, with 7 patients being boys. Lymph nodes were the primary site of involvement in four children. Extranodal involvement was seen in 60%. One patient had the underlying chronic granulomatous disease (CGD). Systemic (B) symptoms were seen in 70%. Three children had hemophagocytic lymphohistiocytosis (HLH) at presentation. All of them had stage-III disease. Seven patients were treated on the Berlin-Frankfurt-Münster-non-Hodgkin lymphomas (BFM-NHL) 90 protocol and three children are currently in remission. Four patients had disease relapse/progressive disease while on therapy. Three children had HLH at presentation and all had poor outcomes.

Conclusions:
Pediatric ALCL has diverse and atypical clinical presentation and a high index of suspicion is needed for diagnosis. ALCL is an aggressive malignancy and is responsive to multiagent chemotherapy, though survival has not improved over the past decade. The integration of novel agents may improve the outcome.
Assessment of the outcomes of eating additional fruits or nuts on periodontal condition – A clinical study
Authors: Dar Ajaz Ahmed , Nissar Insha , Shaktawat Neha , Sharma Supriya , Bhati Rajendra Singh , Tomar Monika 
Published: August 2023

Background:
Periodontal condition is a multifaceted chronic inflammatory condition that necessitates the formation of a pathogenic biofilm, the countenance of which is influenced by a variety of host-dependent factor grounds. The goal of the analyses presented in this article was to establish the outcomes of a huge upsurge in fruit or nut consumption on probing pocket depth.

Materials and Methods:
After the baseline investigations, the participants were randomly assigned to eat an extra 7kcal/kg body weight/day of additional fruit or nuts by drawing ballots. The ratio of randomization was 1:1. When the entire sums of probing pocket depths of the participants that were a minimum of 4-mm deep were compared amid groups, the difference was statistically significant (P = 0.012).

Conclusion:
This randomized trial found no evidence that eating a lot of fruits had a deleterious impact on periodontal condition or infection.
Evaluation and comparison of the antimicrobial activity of herbal extracts with the standard irrigant against Enterococcus faecalis
Authors: Atom Jenny , Devi Ningthoukhongjam Rati , Kangabam Nikita , Thoudam Bebika Devi , Lairenlakpam Ronel , Singh N. Sukumar 
Published: August 2023

Background:
Numerous actions to diminish the number of microorganisms in the root canal system comprise the usage of a variety of functional techniques, irrigation methods, and intracanal medications. Irrigation goes hand in hand with resources to help remove pulp tissue and/or microorganisms.

Purpose:
The intent of this trial was to assess as well as compare the antimicrobial activity of herbal irrigant with normal irrigant (2.5% sodium hypochlorite [NaOCl]) against Enterococcus faecalis to test its effectiveness as root irrigation water.

Materials and Methods:
The culture was elevated overnight at 37°C in brain heart infusion (BHI) broth followed by testing microbial growth for changes in turbidity for 24 h. BHI broth comprising E. faecalis is vaccinated on a BHI agar plate using a grass planting method utilizing a sterile glass dispenser. Five test herbal discs (Curcuma longa [CT]-turmeric, Azadirachta indica [AI], MI, Propolis [P], and Triphala [T]); in addition to two control discs (ethanol as well as NaOCl) positioned on a custom plate.

Results:
The average blocking area with a drop-down program for each drug was observed to be: NaOCl (24.0 ± 1.74) >P (14.6 ± 1.84) > AI (09.5 ± 1.72) > T (06.4 ± 0.83) > CT (04.3 ± 04.1± ±0.83).) > Morinda citrifolia (03.2 ± 0.30) > ethanol (00.1 ± 0.01).

Conclusions:
P and AI have shown assuring outcomes in the completion of E. faecalis. Nevertheless, their work has been observed to be under NaOCl.
Microbiota: un ecosistema inteligente
Authors: Martínez Maria Florencia , Piegari Feliú María Alejandra , Di Matteo María Celeste , Romina Lucrecia Tellería , Edelman Solange , Procchio Marina , Lertora María , Ponti Lucas , Tosi Verónica 
Published: August 2023

La microbiota es el conjunto de microorganismos que habitan en el cuerpo humano, ésta varía en cada individuo y es fundamental para el funcionamiento del sistema inmune y el mantenimiento de la salud. Está determinada por múltiples factores. Una alteración en la composición de la misma puede generar un efecto proinflamatorio que puede llevar al desarrollo de enfermedades sistémicas, entre ellas enfermedades cutáneas. El estudio de la microbiota parece ser un campo prometedor para entender la fisiopatología de muchas entidades y el uso de pro, pre y sinbióticos se encuentra aún en estudio y podría generar nuevas modalidades terapéuticas.
Mitos y verdades. Lesión intraepitelial vulvar de alto grado
Authors: Cilio Antonella María 
Published: August 2023

1. El agente etiológico de la lesión intraepitelial vulvar de alto grado (HSIL, por su sigla en inglés) es el virus del papiloma humano (HPV) de alto riesgo. La infección persistente confiere un riesgo de progresión al cáncer de vulva invasor.
2. Las lesiones HSIL se caracterizan por su color rosado y siempre son sintomáticas (prurito o dolor).
3. El imiquimod tópico es el tratamiento de primera línea en las mujeres inmunocompetentes con lesiones unifocales.
Upaya Penggunaan Media Visual Tiga Dimensi untuk Meningkatkan Minat Belajar Siswa Mata Pelajaran Kewarganegaraan di SMK Nurul Iman Bantul
Authors: Noviati Nunik , Budiutomo Tri Wahyu 
Published: August 2023

The problem of education in Indonesia is very complex, especially in terms of teaching aids. In this era of globalization, there are many learning methods used by teachers or teaching staff, one of which is visual media. With this visual media, the main goal is to be able to attract students' interest in learning Pendication Kewarganegaraan is much more efficient and effective, because the visual media that researchers expose is a three-dimensional visual media like a puzzle called the Garuda Lima Pilar Medal. This medium is created in such a way, which is interesting and constructed so that what the student learns can be easily understood, understood, remembered, and then its meaning can be applied in daily life.
A Clinical Audit: Ventriculoperitoneal Shunt for Patients with Hydrocephalus
Authors: Perdawd Khawand Saeed 
Published: August 2023

Purpose: Hydrocephalus, abnormal accumulation of CSF in the ventricles, is one of the most common diseases of the brain. Ventriculoperitoneal shunting is one of the commonest procedures for management of hydrocephalus. Assessment and evaluation of the clinical outcome, following VP shunt, should be carried out to decrease rates of complications of this procedure. Clinical audit plays a vital role in identifying and developing effective methods for improving patient care. This paper sheds light on 37 neurosurgical patients with hydrocephalus who underwent ventriculoperitoneal shunt surgery. Our aim was to identify defects in steps in management of hydrocephalus by VP shunt from time of admission to discharge.
Methodology: In this audit study 37 patients with hydrocephalus were selected between November, 2021 and December, 2022 at West Erbil emergency hospital and Erbil teaching hospital. VP shunt surgery was performed for them. Information was gathered from patient records, diagnostic imaging, and operation notes, and subsequent clinical follow-up evaluations were carefully analyzed and reviewed. The gathered data encompassed demographic details, clinical manifestations, radiological studies, reasons for surgery, operative findings, and complications associated with the shunt.
Findings: The prevalent causes observed were congenital hydrocephalus (45.9%), posterior fossa tumors (13.5%), and post meningitis hydrocephalus (18.9%). A right-sided VP shunt utilizing a medium-pressure valve system emerged as the most prevalent treatment modality. Three patients exhibited symptoms and signs indicative of shunt infection. Additionally, one patient experienced an epidural hematoma at the site of the burr hole.
Unique contribution to theory, practice and policy: Patients with hydrocephalus and undergoing VP shunt surgery should be evaluated carefully and every step from time of admission to discharge is crucial in decreasing the complications which are associated with this surgery.
Lipid Panel Screening for Adults Living With Chronic Conditions
Authors: Brett Kendra , MacDougall Danielle 
Published: August 2023

Abnormal blood lipid levels are associated with increased risk of cardiovascular disease, and lipid panel screening can help health care providers make treatment decisions for adults living with chronic conditions.
We did not find any studies that met our inclusion criteria on the diagnostic test accuracy or clinical utility of nonfasting lipid panel screening for adults living with chronic conditions.
Two guidelines recommend a nonfasting lipid panel for the initial screening for cardiovascular disease risk. A fasting lipid panel is recommended if triglyceride levels are high.
One guideline recommends either fasting or nonfasting lipid panel screening before starting lipid modification therapy in people at risk of cardiovascular disease.