bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extralesional triamcinolone acetonide injection in the treatment of small chalazion
Authors: Gan Lu , Liu Yi , Zhou Xiaoting , Xue Kang , Guo Jie , Qian Jiang , Ren Hui 
Published: August 2023

Purpose:
To evaluate the effect of extralesional triamcinolone acetonide (TA) injection in the treatment of small chalazion (diameter ≤ 5 mm).

Methods:
Prospective interventional clinal study that included patients diagnosed as chalazion of small size not responding to conservative management for at least 2 weeks. All patients were treated with extralesional TA injection (4 mg). Successful resolution of a chalazion was defined as a decrease in size to 1 mm or smaller.

Results:
Thirty-eight patients were included in the study. The resolution was achieved in 33 (87%) patients. Nineteen (50%) patients had complete resolution after the first injection, and 13 (34.2%) patients had complete resolution after the second injection. Chalazion near the lower punctum needed more times of injections than those elsewhere (P = 0.02).

Conclusions:
Extralesional TA injection is effective in the treatment of both primary and recurred small chalazia. It is a simple and cost-saving procedure and can be considered an alternative first-line treatment for small chalazion.
Comparative Clinical and Histopathological Evaluation of Mature and Nonmature Arteriovenous Fistula
Authors: Mahapatra Himansu Sekhar , Kushal D P , Kaur Navjot , Bhardwaj Minakshi , Pursnani Lalit , Muthukumar B , Singh Anamika , Krishnan Chandra , Kumar Adarsh , Binoy Renju 
Published: August 2023

Introduction:
Nonmaturation of arteriovenous fistula (AVF) is a common obstacle due to neointimal hyperplasia (NIH). The present study evaluated the clinical and histopathological factors predicting AVF nonmaturation.

Methodology:
This prospective observational study was conducted over 18 months in 100 patients. AVF site venous tissue samples of 55 4/5 chronic kidney disease stages patients were collected. Histopathological analysis was done to detect four immunohistochemistry (IHC) markers, namely cluster of differentiation (CD68), CD31, α-SMA, and Ki67. IIntimal composition, hyperplasia, and calcification were also assessed. Fistulae were followed up at the 2nd, 6th, and 12th weeks and classified into mature and nonmature groups at 12 weeks based on clinical and Doppler examination. A comparison between the two groups was done and an association of radiological, histopathological, and IHC parameters of nonmature AVF was also carried out.

Results:
Among 55 patients, 35 (63.6%) had mature AVF and 26 (47%) had preexisting NIH. Preexisting NIH had no significant association with maturation (odds ratio: 0.44). Subjects without preexisting NIH had a significantly higher luminal diameter in 2nd week (P ≤ 0.05). There was a significant increase in blood flow both between the 2nd and 6th and between the 6th and 12th week (P < 0.05). Of the four IHC markers, three markers viz., CD68 (r = 0.525), CD31 (r = 0.420), and α-smooth muscle actin (r = 0.718) correlated significantly (P < 0.05) with the NIH. The mean AVF diameter and blood flow in the matured arm were more than that in the nonmatured arm at all the follow-ups (P < 0.09).

Conclusion:
The presence of CD68, CD31, and α-smooth muscle actin in the venous tissue suggests preexisting NIH which postoperative luminal diameter and blood flow may have long-term consequences in AVF functioning.
An Observational Study on Transposed Brachial Artery ‒ Basilic Vein AV Fistula in Vascular Access for Hemodialysis
Authors: Jha Manvendu , Vembu Anand , Dhillan Rishi 
Published: August 2023

Background:
Dialysis access in patients of chronic kidney disease (CKD) on long-term hemodialysis is a problem area. Patients with poor caliber veins distally on initial evaluation or with multiple fistula failures, basilic vein transposition is a good alternative. We present our experience with basilic vein transposition at our center.

Methods:
This study was a single-center observational study. A retrospective review of prospectively collected data from December 2013 to June 2019 was done. Qualitative variables were expressed as frequencies/percentages and compared between groups using the Chi-square test. Quantitative variables were expressed as mean ± standard deviation and compared between groups using unpaired t-test between groups and paired t-test within groups across follow-ups. Multiple linear regression analysis using a stepwise model selection tool was used to assess factors affecting the first cannulation. The best model was arrived in four steps where explanatory power (R
2) increased from 66.6% to 79.3% (P < 0.001).

Results:
One hundred and eighty-eight patients formed a part of the study. One hundred and sixty-four patients underwent single stage, whereas 24 underwent two-stage transposition. Ninety-four each were male and female. The mean age was 51.38 ± 14.74 years. About 96.27% of fistulas underwent successful cannulation. The overall mean maturation time was 44.46 ± 7.21 days. It was 42.28 ± 3.71 for single and 60.27 ± 6.66 days for two-stage procedures. Primary patency at 6 months and 1 year were 92.82% and 85.67%, whereas primary-assisted patency rates were 94.6% and 91%. The secondary patency rate at 1 year was 60.77%. Salvage procedures included thrombolysis in 2, thrombectomy in 18, and thrombectomy with venoplasty in four cases. There were 28 failures. Fistula thrombosis was the most common cause. Complications included transient arm edema in 36.7%, late thrombosis in 7.7%, wound infection in 4.4%, and lymphorrhea in 6.9% of patients.

Conclusion:
The smallest basilic vein diameter for successful transposition is 2.5 mm. Factors used to predict successful maturation are initial vein diameter ≥2.5 mm, preoperative Peak systolic velocity (PSV) in brachial artery >70 cm/s, fistula flow rate of >400 ml/min at 6 weeks, and fistula diameter >4.5 mm at 06 weeks.
Hemoperfusion in patients with severe COVID-19 respiratory failure, lifesaving or not?
Authors: Abbasi Saeed , Naderi Zohre , Amra Babak , Atapour Abdolamir , Dadkhahi Seyed Amir , Eslami Mohammad Javad , Hajian Mohammad Reza , Hashemi Marzieh , Hashemi Seyed Taghi , Iraj Bijan , Khorvash Farzin , Madadi Samane , Pour Hossein Mahjoubi , Mansourian Marjan , Rezvani Majid , Sami Ramin , Soltaninejad Forough , Shahidi Shahrzad , Vahdat Sahar , Zamani Zahra , Moeinzadeh Firouzeh 
Published: August 2023

Background:
The new coronavirus outbreak quickly filled hospital beds and stunned the world. Intensive care is required for 5% of patients, and the mortality rate for critically ill patients is 49%. The “cytokine storm” is considered as the main cause of pathogenesis for coronavirus disease-19 (COVID-19)-related respiratory failure, hemoperfusion may be a modality for treatment of disease.

Materials and Methods:
Thirty-seven an patients with positive real-time polymerase chain reaction for SARStions2 in an upper respiratory tract sample or typical chest computed tomography lesion were eligible for this case–control study. Patients meeting the criteria for hemoperfusion including clinical and laboratory indices, were evaluated for outcomes such as hospitalization length and mortality. Patients were divided into three groups, i.e., patients who received hemoperfusion without a need for mechanical ventilation (MV), patients who received hemoperfusion before MV, and patients who received hemoperfusion after MV.

Results:
Among 37 patients with COVID-19 respiratory failure, 32% were female with a mean age of 55.54 (standard deviation 14.1) years. There was no statistically significant difference between the three groups in terms of length of hospital stay and intensive care unit (ICU) stay (P-tayns: 0.593 and 0.243, respectively, confidence interval [CI]: 95%). Heart rate, respiratory rate, PaO2/FIO2, high-sensitivity C-reactive protein, and ferritin significantly improved after the application of hemoperfusion in all groups (P < 0.05, CI: 95%).

Conclusion:
It seems that applying hemoperfusion in the inflammatory phase of the disease, especially before the intubation, reduce the need for MV. However, hemoperfusion does not have any impacts on the duration of hospital and ICU stay.
Are total bilirubin and high-sensitivity C-reactive protein independently associated with Type 2 diabetes mellitus in postmenopausal women?
Authors: Klisic Aleksandra , Kavaric Nebojsa , Ninic Ana 
Published: August 2023

Background:
Various studies have reported contradictory results regarding the relationship of total bilirubin and high-sensitivity C-reactive protein levels (hsCRP) with diabetes mellitus Type 2 (DM2). Therefore, we aimed to examine which one of them could be more convenient for the estimation of DM2 risk in postmenopausal women.

Materials and Methods:
A total of 150 healthy postmenopausal women (mean age 57[53–60] years) and 79 postmenopausal women with DM2 (mean age 66 [61–71] years) were enrolled in cross-sectional study. Examinees were recruited consecutively in the study during their regular check-up visit in the Primary Health Care Center in Podgorica, Montenegro, in a period from October 2012 to May 2016. Anthropometric measurements, biochemical parameters, and blood pressure were obtained. Multivariable logistic regression analysis was used to find the independent predictors for DM2 development in postmenopausal women.

Results:
Age, waist circumference, and total bilirubin were the independent predictors for DM2 development in postmenopausal women (odds ratio [OR] =1.224, 95% confidence interval [CI] [1.117–1.341], P < 0.001; OR = 1.137, [95% CI = 1.036–1.215], P < 0.001, and OR = 0.727, [95% CI = 0.611–0.866], P < 0.001, respectively), whereas hsCRP lost its independent predictive role (OR = 1.155, [95% CI = 0.854–1.560], P = 0.349).

Conclusion:
Unlike hsCRP, total bilirubin independently correlated with DM2 in postmenopausal women.
The real-time reproduction number, impact of interventions and prediction of the epidemic size of COVID-19 in the center of Iran
Authors: Moradzadeh Rahmatollah , Jamalian Mohammad , Nazari Javad , Hosseinkhani Zahra , Zamanian Maryam 
Published: August 2023

Background:
The monitoring of reproduction number over time provides feedback on the effectiveness of interventions and on the need to intensify control efforts. Hence, we aimed to compute basic (R0) and real-time (Rt) reproduction number and predict the trend and the size of the coronavirus disease 2019 (COVID-19) outbreak in the center of Iran.

Materials and Methods:
We used the 887 confirmed cases of COVID-19 from February 20, 2020, to April 17, 2020 in the center of Iran. We considered three scenarios for serial intervals (SIs) with gamma distribution. Rt was calculated by the sequential Bayesian and time-dependent methods. Based on a branching process using the Poisson distributed number of new cases per day, the daily incidence and cumulative incidence for the next 30 days were predicted. The analysis was applied in R packages 3.6.3 and STATA 12.0.

Results:
The model shows that the Rt of COVID-19 has been decreasing since the onset of the epidemic. According to three scenarios based on different distributions of SIs in the past 58 days from the epidemic, Rt has been 1.03 (0.94, 1.14), 1.05 (0.96, 1.15), and 1.08 (0.98, 1.18) and the cumulative incidence cases will be 360 (180, 603), 388 (238, 573), and 444 (249, 707) for the next 30 days, respectively.

Conclusion:
Based on the real-time data extracted from the center of Iran, Rt has been decreasing substantially since the beginning of the epidemic, and it is expected to remain almost constant or continue to decline slightly in the next 30 days, which is consequence of the schools and universities shutting down, reduction of working hours, mass screening, and social distancing.
The side effect profile of sirolimus and its relationship with some variables: A retrospective study of Iranian renal transplant patients
Authors: Shahidi Shahrzad , Vahdat Sahar , Atatpour Abdolamir , Meshkinfar Shirin 
Published: August 2023

ABSTRACT

Background:
Sirolimus is a potent immunosuppressive in renal transplantation. However, its use is limited by some reported side effects. The objective of this study was to determine the side effect profile of sirolimus in renal transplant patients.

Materials and Methods:
In the present study, we retrospectively reviewed the medical records of 116 renal transplant patients treated with sirolimus alone or in combination with other immunosuppressive agents at private therapeutic centers in Isfahan, Iran, between March 2009 and February 2020. A checklist was used to collect data on demographic and clinical variables. Data were analyzed with independent samples t-test and Chi-squared test.

Results:
Our findings indicated that the most prevalent sirolimus-related side effects were edema (42.3%), proteinuria (37.5%), cytopenia (26.9%), abnormal level of liver enzymes (11.7%), and pneumonitis (9.7%). Stratification of side effects by sirolimus dose (<2 mg and ≥2 mg) demonstrated their dose-independent occurrence (P > 0.05). Pneumonitis was the most frequent reason for sirolimus cessation (58.7%). No significant differences were observed between males and females regarding the frequency of reasons for sirolimus cessation (P > 0.05).

Conclusion:
Edema, proteinuria, cytopenia, abnormal level of liver enzymes, and pneumonitis were the most prevalent sirolimus-related side effects in renal transplant patients. Further prospective cohort studies are warranted to detect underlying mechanisms and determinants of these side effects in renal transplant patients treated with sirolimus.
Estimating the best fraction of inspired oxygen for calculation of PaO2/FiO2 ratio in acute respiratory distress syndrome due to COVID-19 pneumonia
Authors: Kadkhodai Leila , Saghaei Mahmoud , Habibzadeh Mohammadreza , Alikiaii Babak , Hashemi Seyed Jalal 
Published: August 2023

Background:
The ratio of partial pressure of oxygen in arterial blood (PaO2) to the fraction of inspiratory oxygen concentration (FiO2) is an indicator of pulmonary shunt fraction. PaO2/FiO2 (P/F) ratio is used to classify severity of acute respiratory distress syndrome (ARDS). With the same shunt fraction, P/F ratio decreases with increases in FiO2 which may lead to errors in classifying severity of ARDS. The effect of FiO2 on P/F ratio has not been investigated in COVID-19 pneumonia. In this study, we estimated the best FiO2 for the calculation of P/F ratio in a sample of patients with ARDS due to COVID-19 pneumonia.

Materials and Methods:
Blood gas and ventilatory data of 108 COVID-19 ARDS patients were analyzed in a cross-sectional observational study. Using Oxygen Status Algorithm the calculated shunt fraction served a basis for calculating P/F ratio for different FiO2. The severity of ARDS determined by P/F ratios at each FiO2s was compared with the shunt-based severity to find the optimum FiO2 for calculation of P/F ratio so the resulting classification has the best match with the reference classification.

Results:
A FiO2 of 1.0 for calculation of P/F ratio and ARDS classification showed the best match with shunt-based ARDS classification. A regression model was obtained with the PaO2, patient's original FiO2, Hemoglobin concentration, and SaO2 as the independent predictors of the P/F ratio for the FiO2 of 1.0.

Conclusion:
This study shows a FiO2 of 1.0 as the best value for correct calculation of P/F ratio and proper classification of ARDS.
Impact of Titanium-Prepared Platelet-Rich Fibrin in Type 1 Fascia Graft Tympanoplasty on Graft Survival and Hearing Outcomes
Authors: Yavuz R , Arslan S , Imamoglu M , Isık AU , Bahadır O , Cobanoglu HBY , Yavuz HB 
Published: August 2023

ABSTRACT

Background:
Type 1 fascia graft tympanoplasty (T1FGT) is the mainstay surgical approach for the treatment of tympanic membrane perforations. The most widely used graft material is temporal muscle fascia, and graft take rates are reported differently. The methods to enhance graft take are still being investigated. Aim: The aim of our study was to investigate the effect of titanium-prepared platelet-rich fibrin (T-PRF) on graft take and hearing outcomes in T1FGT.

Materials and Methods:
Fifty-seven ears eligible for T1FGT were involved in the study and prospectively evaluated. T-PRF was applied with T1FGT in 27 ears. Thirty ears in the other group underwent only T1FGT. The patients underwent an otomicroscopic and audiometric examination in preoperative and postoperative 2nd week, 1st month, and 6th month. Both groups were evaluated in terms of hearing levels, infection, and graft take rates.

Results:
Two patients in the T1FGT + T-PRF group and seven patients in the T1FGT group had postoperative perforation (graft take rate: 92.6% versus 76.7%). The graft take rate was found to be increased in the T-PRF group although the difference was not statistically significant. In the T1FGT group, the percentage of infection was higher than in the T1FGT + T-PRF group. When the preoperative and postoperative 6th-month audiometry was compared, a statistically significant hearing gain was obtained for both groups.

Conclusion:
In the treatment of tympanic membrane perforations, T-PRF applied over the fascia graft was shown to increase graft take rates and decrease the probability of infection. Further studies with larger samples are needed to demonstrate the effects of PRF.
Correlation between Bladder Wall Thickness and Uroflowmetry in West African Patients with Benign Prostatic Enlargement
Authors: Okeke CJ , Jeje EA , Obi AO , Ojewola RW , Ogunjimi MA , Tijani KH 
Published: August 2023

ABSTRACT

Background:
Pressure flow urodynamic study remains the gold standard for the diagnosis of bladder outlet obstruction; however, their use is limited by their relative unavailability in our environment, cost, and invasiveness. Measurement of bladder wall thickness (BWT) by transabdominal ultrasonography is a promising tool that can be used to diagnose bladder outlet obstruction in our environment where pressure-flow urodynamic study is not readily available.

Objective:
The study aimed to correlate BWT with uroflowmetry and to establish a BWT cut-off in patients with lower urinary tract symptoms (LUTS) due to benign prostatic enlargement.

Materials and Methods:
This was a prospective one-year study of patients with LUTS due to benign prostatic enlargement. The patients were divided into obstructed and non-obstructed groups with Q- max of 10 ml/s serving as the cut-off value. Receiver Operator Curve (ROC) was used to evaluate the performance of BWT in diagnosing BOO. Statistical significance was set at P < 0.05.

Results:
The mean BWT and Q-max were 4.53 ± 2.70 mm and 15.06 ± 9.43 ml/s. There was a negative correlation between BWT and Q-max (r = -0.452, P = 0.000), Q-average (r = -0.336, P = 0.000), and voided volume (r = -0.228, P = 0.046). A BWT cut-off of 5.85 mm was found to be the best threshold to differentiate obstructed from non-obstructed patients with a sensitivity and specificity of 70 and 88.2 percent respectively.

Conclusion:
Bladder wall thickness showed an inverse relationship with maximum flow rate with high sensitivity and specificity. This non-invasive test can be used as a screening tool for BOO in our setting, where the pressure flow urodynamic study is not readily available.
PELATIHAN PENYELENGGARAAN JENAZAH DI DUSUN RUMPALA DESA BOTOLEMPANGAN KECAMATAN SINJAI BARAT KABUPATEN SINJAI
Authors: Irfan  , Ridwan Hardiyanti , K Sulfikar , Wahidayanti Wahidayanti 
Published: August 2023

Penyelenggaraan jenazah yaitu sejak sejak dari menyiapkannya, memandikannya, mengkhafaninya, menshalatkannya, membawanya ke kubur sampai kepada menguburkannya adalah perintah agama yang ditujukan kepada kaum muslimin sebagai kelompok masyarakat. Tujuan dari program kerja ini dilaksanakan untuk memahamkan masyarakat setempat terkait penyelenggaraan jenazah dan kurangnya SDM sehingga penulis menyediakan fasilitas penyelenggaraan jenazah. Program kerja ini dilaksanakan selama satu hari dengan beberapa persiapan yang maksimal. Hasil dari program kerja yang dilakukan oleh penulis yaitu memberikan pemahaman terhadap masyarakat setempat mengenai pelatihan penyelenggaraan jenazah di Desa Botolempangan Kec. Sinjai Barat Kab. Sinjai.
Análisis de los factores determinantes que influyen en la morosidad crediticia, Puno, Perú.
Authors: Jallo Sanga Maritza Magdalena , Ticona Carrizales Lucio , Apaza Panca Cynthia Milagros , Ticona Condori Madeleine Nanny , Rodríguez Chokewanca Ingrid Rossana 
Published: August 2023

Considerando lo pertinente a que la asignación de créditos es la principal actividad que llevan a cabo los bancos y, a su vez, es fuente esencial de sus ingresos, de tal manera la morosidad es un tema muy preocupante para una entidad crediticia; es por eso que el objetivo del presente estudio de investigación es identificar y explicar los factores determinantes que influyen en la morosidad crediticia de la localidad de Puno, periodo 2009 al 2019. Para ello se propuso el método deductivo-inductivo y analítico que involucra el tratamiento de las variables de series de tiempo con un modelo econométrico lineal, por mínimos cuadrados ordinarios, en la que nos permitió analizar los determinantes de la morosidad como variable dependiente está siendo explicada significativamente por el PBI, es variable macroeconómica, y variables microeconómicas dentro de la localidad de Puno; y en forma conjunta son significativos, y estas variables van a contribuir a la alta morosidad. Considerando lo pertinente a que la asignación de créditos es la principal actividad que llevan a cabo los bancos y, a su vez, es fuente esencial de sus ingresos
Moderating Influence of the Legal and Regulatory Framework on Precursors of Sustainability of Donor Funded Projects in the Health Sector in Kenya
Authors: Micheni Alice Kanini , Were Susan , Namusonge Gregory 
Published: August 2023

Purpose: The objective of the study was to find out the moderating influence of the legal and regulatory framework on sustainability of donor funded projects in the health sector in Kenya.
Methodology: This study used a mixed method research design where both quantitative and qualitative data were collected, then analyzed, and conclusions drawn. The research design used was explanatory. The target population was 700 employees drawn from various stakeholders in the health sector. The study adopted stratified, purposive, and simple random sampling techniques to select a sample of 230 respondents. The study used questionnaires to collect primary data. The data was analyzed using the Statistical Package for Social Sciences (SPSS) version 27.
Findings: The findings revealed that the legal and regulatory framework has a moderating effect on the relationship between stakeholder engagement, resource mobilization, process execution & leadership practices and sustainability of donor funded projects in the health sector in Kenya.
Unique Contribution to Theory, Policy, and Practice: The study recommended that the health sector in Kenya should strengthen the frameworks for stakeholder engagement in health-related projects and that policies should be reviewed and re-designed to support activities in the space of donor funded projects if sustainability of projects has to be achieved. The study further recommends that there is need for tools and frameworks that would ensure that leadership practices are aligned to achieve project sustainability.