bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical outcomes of premeatal and retromeatal cerebellopontine angle meningioma in Vietnam: a single-center prospective cross-sectional study
Authors: Pham Duy , Nguyen Anh Duc , Do Toan Thanh Thi , Kieu Hung Dinh 
Published: April 2023

Background:
Cerebellopontine angle (CPA) meningiomas are the second most common tumor of the CPA. Depending on the site of dural attachment, the relationship between the tumor and critical neurovascular structures of the CPA is variable. This study aims to evaluate the influence of CPA meningioma location in relation to the internal auditory canal (IAC) on clinical symptoms, radiological presentations, and surgical treatments and outcomes which has been rarely reported in Vietnam.

Patients and methods:
A prospective study on 33 patients treated with microsurgery from August 2020 to May 2022 at the Neurosurgery Center, Viet Duc University Hospital.

Results:
The mean age of 27 females (85%) and 6 (15%) males was 54±12 years. Based on their location to the IAC, there were 16 premeatal cases (49%) (anterior to the IAC) and 17 retromeatal cases (15%) (posterior to the IAC). The time of diagnosis of the retromeatal group was later (16.5 vs. 9.7 months), the average tumor size of the 2 groups was not different, but when there was brainstem compression, the average tumor size of retromeatal group was larger (49 vs. 44 mm). The clinical presentations of the retromeatal group were related to the cerebellar symptoms, while trigeminal neuropathy symptoms all came from the premeatal group. Gross total resection of the premeatal group was 31% and of the retrometal group was 71%. The results of preserving the facial nerve function of the premeatal group were lower (44 vs. 82%). Postoperative Karnofsky score of the retromeatal group improved, while the premeatal group did not change.

Conclusions:
Classification of CPA meningiomas according to their location to the IAC plays an important role in diagnosis and treatment, affecting clinical symptoms, surgical strategy as well as surgical outcomes.
Diffuse large B-cell lymphoma in a patient treated with azathioprine for ulcerative colitis: a case report
Authors: Sedai Hari , Shrestha Suraj , Chand Vikash , Poddar Elisha , Acharya Suman , Koirala Dinesh 
Published: April 2023

Introduction and importance:
Azathioprine (AZA) used as an immunomodulator agent in the management of inflammatory bowel disease (IBD) increases the risk of the development of lymphoma.

Case presentation:
We present a case of a 45-year-old female receiving AZA for severe ulcerative colitis for 4 years. She presented with the chief complaints of bloody stool and abdominal pain for 1 month. Through a series of investigations including colonoscopy, contrast-enhanced computed tomography scan of the abdomen and pelvis, and biopsy with immunohistochemistry; she was diagnosed to have diffuse large B-cell lymphoma of the rectum. She is currently on a chemotherapeutic regimen and is planned for surgical resection after the completion of neoadjuvant therapy.

Clinical discussion:
AZA is classified as a carcinogen by the International Agency for Research on Cancer. Prolonged exposure to higher doses of AZA increases the risk of developing lymphoma in IBD. Previous meta-analysis and research indicate that the risk of development of lymphoma after the use of AZA in IBD increases by about four- to six-fold, especially in older age groups.

Conclusions:
AZA may increase the susceptibility to developing lymphoma in IBD, but the benefit far outweighs the risk. Precautions must be taken in prescribing AZA in older individuals which mandates periodic screening.
Coexistence of multiple clear cell papillary renal cell carcinoma with renal oncocytoma: a case report
Authors: Hermi Amine , Saadi Ahmed , Mokadem Seif , Blel Ahlem , Chakroun Marouene , Ben Slama Mohamed Riadh 
Published: April 2023

Introduction and importance:
Clear cell papillary renal cell carcinoma (CCPRCC) is a new entity, previously known as unclassified renal cell carcinoma, and initiallly identified in patients suffering of end-stage kidney failure. It is extremely rare to see this new entity associated with others renal malignant lesions.

Case presentation:
The authors report a case of a female 65-year-old suffering from end-stage kidney failure for 10 years, who presented with a double left renal tumor, composed by an oncocytoma associated to multiple CCPRCC, a very rare entity. A radical left nephrectomy was realized by lumbotomy, with an uneventful postoperative course. Histological examination was challenging. Immunohistological examination showed diffuse positivity of cytokertain 7. No local recurrence nor metastatic progression were found during the 12 months of follow-up.

Clinical discussion:
CCPRCC, is a new entity, previously known as the unclassified rena cell carcinoma, is a malignant renal tumor, initially reported in patients at end-stage kidney failure. Oncocytoma is a well-known rare benign renal tumor. The association of both is rare, and should be kept in mind, especially when scanoguided diagnosis biopsy is realized. Histopathological confirmation may be challenging, given the recent identification of CCPRCC. The nuclei disposal toward the luminal surface is a characteristic pathological landmark of CCPRCC. Immunohistopathological examination is of great help, showing a distinctive profile: diffuse staining for cytokertain 7 and carbonic anhydrase IX.

Conclusion:
CCPRCC is a new malignant pathological entity in renal tumors. It can be associated with other benign renal lesions. This should be taken into consideration while histopathological examination, mainly of scanoguided biopsy cores.
Challenges in diagnosing vaginal mass in a pregnant woman with an underlying duplex collecting system disease: a case report
Authors: Baroudi Ihsan , Mourad Danya , Salman Adnan 
Published: April 2023

Introduction and importance:
Congenital renal anomalies are a sequence of defective renal parenchymal or collecting system development and migration that may be discovered during the prenatal period or incidentally among adults. Duplex collecting system diagnosing in adults represents a challenge to physicians. Long-term history of urinary tract infections besides vaginal mass in pregnant women should raise the suspicion of underlying urinary tract malformation.

Case presentation:
In this case, a 23-year-old pregnant woman at 32 weeks came to the clinic for a routine check-up. A vaginal mass had been noticed during the examination and was punctured, revealing unknown fluid. Further investigations revealed left duplex collecting system consisted of an upper moiety opening with a ureterocele in the anterior wall of the vagina and a lower moiety ending with an ectopic orifice near the right ureter orifice. Therefore, the modified Lich–Gregoir procedure was done to reimplant the ureter of the upper renal moiety. Postoperative following-up investigations affirmed improvement without complications.

Clinical discussion:
The duplex collecting system disease may remain asymptomatic until adulthood or present with unexpected symptoms. The subsequent workup in the duplex kidney disease depends on the moieties’ function and the ureter orifice opening site. Although the Weigert–Meyer rule is usually used to describe the typical pattern of duplex collecting system ureters opening sites, it has many expectations in the literature.

Conclusion:
This case shows how some common symptoms may lead to finding an unexpected urinary tract abnormality.
Management of blunt renal trauma on pre-existing diseased kidneys: a cross-sectional study
Authors: Saadi Ahmed , Maatougui Jasser , Hermi Amine , Mokadem Seif , Boussaffa Hamza , Zaghbib Selim , Bellali Mohamed , Allouche Mohamed , Jrad Mariem , Ayed Haroun , Bouzouita Abderrazak , Derouiche Amine , Chakroun Marouene , Ben Slama Mohamed R. 
Published: April 2023

Introduction:
Pathological kidney trauma is a special entity. Congenital or acquired lesions may interfere with clinical presentation, radiological imaging, and the therapeutic approach.

Objective:
Our objective was to determine the clinical, radiological, and therapeutic features of this entity.

Materials and methods:
The medical records of 37 observations were retrospectively collected from January 1992 to February 2022. All cases were explored by a kidney ultrasound and/or a computed tomography scan, and classified according to the American Association of Surgery of Trauma. Pre-existing renal abnormalities were found in 37 patients among 203 (18.2%). The most common underlying lesion were urolithiasis (37.8%) followed by pyelo-ureteral junction syndrome (32.4%). Surgical abstention was decided in 11 cases, four nephrectomies were performed as a matter of urgency, and seven nephrectomies were performed remotely. The cure of uropathy was performed after an average delay of 3 months.

Conclusion:
Kidneys with underlying pathology are habitually more susceptible to trauma. Contusions are often benign contrasting with a high nephrectomy rate.
Combination of Cattell-Braasch and Kocher maneuver in laparotomy for diverticular resection in the third part of the duodenum: a case report
Authors: Handaya Adeodatus Y. , Utomo Bambang P. , Andrew Joshua , Hanif Ahmad S. , Tjendra Kevin R. , Subroto Polycarpus D. , Susilo Naufal C.J. , Aditya Azriel F.K. 
Published: April 2023

Introduction:
A duodenal diverticulum is an outpouching of all or partial layers of the duodenal wall. Duodenal diverticulum complications such as bleeding, diverticulitis, pancreatitis, choledochal occlusion, and perforation can develop. Localization of the diverticulum in the third part of the duodenum is rare. Surgical intervention with a combination of Cattell-Braasch and Kocher maneuvers in laparotomy is currently emerging as a viable option.

Case presentation:
The authors report a case of a 68-year-old male with chief complaints of black stool and recurring epigastric pain. Barium follow-through showed diverticulum at the third part of the duodenum. Surgery with a combination of Cattell-Braasch and Kocher’s maneuvers using a linear stapler was successful, and there were no intraoperative or postoperative complications. Postoperative barium follow-through showed no diverticulum residue. The patient had no more complaints of black stools nor epigastric pain.

Clinical discussion:
Symptomatic duodenal diverticulum is a rare case with a very small chance of complications. Due to its lack of specific symptoms, imaging examinations play a better role in diagnosis. Surgical intervention is also rarely performed due to the small chance of complications. Diverticulectomy with the use of Cattell-Braasch and the extended Kocher maneuver results in better duodenum exposure, and the usage of a linear stapler also made the surgery safer and quicker to perform.

Conclusion:
The authors propose that a diverticulectomy of the third part of the duodenum performed with a combination of the Cattell-Braasch and Kocher maneuvers with the use of a linear stapler as a safe procedure.
Diagnostic accuracy of two-dimensional and three-dimensional transesophageal echocardiography in detecting pannus and thrombus in left mechanical valve obstruction
Authors: Pham Thao Thi Thanh , Kirkpatrick James N. , Duong Hung Duc , Pham Hung Manh , Vu Thom Thi , Giap Nguyet Thi Minh , Trinh Ha Viet , Nguyen Yen Thi Hai , Hoang Mai Thi Ngoc , Nguyen Hoai Thi Thu 
Published: April 2023

Aims:
The aim of this study was to determine the accuracy of two-dimensional and three-dimensional transesophageal echocardiography (TEE) in the detection of pannus and thrombus in left mechanical valve obstruction (LMVO) compared with surgical and histopathology findings.

Materials and methods:
Patients with suspected LMVO on transthoracic echocardiography were enrolled consecutively. All patients underwent two-dimensional and three-dimensional TEE, and open-heart surgery to replace obstructed valves. Macroscopic and microscopic analysis of the excised masses was used as the gold standard for the diagnosis of thrombus and/or pannus.

Results:
Forty-eight patients [34 women (70.8%), age 49±13 years, New York Heart Association II: 68.8%, New York Heart Association III: 31.2%] were enrolled. In the diagnostic of thrombus, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of three-dimensional TEE were 89.2, 72.7, 85.4, 91.7, and 66.7%, respectively, compared with those of two-dimensional TEE (42.2, 66.7, 43.8, 95, and 7.1%, respectively). In the diagnosis of pannus, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of three-dimensional TEE were 53.3, 100, 85.4, 100, and 82.5%, respectively; compared with those of two-dimensional TEE (7.4, 90.5, 43.8, 50, and 43.2%, respectively). Receiver operating characteristic curves depict that the area under the curves of three-dimensional TEE was higher than the area under the curves of two-dimensional TEE in both diagnoses of thrombus and pannus (0.8560 vs. 0.7330, P=0.0427 and 0.8077 vs. 0.5484, P=0.005, respectively).

Conclusions:
This study indicated that three-dimensional TEE had a higher diagnostic value than two-dimensional TEE in the detection of thrombus and pannus in patients with LMVO, and can be a reliable imaging modality to identify the causes of LMVO.
Perceived caregiver’s burden among children with autism spectrum disorder in central Nepal: a cross-sectional study
Authors: Shrestha Manju , Shrestha Navina , Khand Yugant , Sherpa Lhamu 
Published: April 2023

Introduction:
Autism spectrum disorder (ASD) is the most common childhood neurodevelopmental disorder characterized by an atypical social and communicative functioning and restricted, repetitive patterns of behaviour activities. Caring for children with ASD is challenging for both parents and their caregivers. This study aims to explore the psychosocial burden of the caregivers of children with ASD.

Materials and methodology:
An analytical cross-sectional study was performed in Centre for Autism in Kathmandu, Nepal. The enrolment occurred between January 2022 and July 2022 among the caregivers of children with ASD. One hundred twenty caregivers in contact with the centre was evaluated using the Zarit Burden Interview-22 during the study period meeting inclusion criteria.

Results:
Our study showed that majority of caregivers among child with ASD were mothers 65 (54.16%, n=65) followed by grandparents 35 (29.16%, n=35) and father 13 (10.8%), respectively. Among them, most of the caregivers perceived moderate to severe burden 57 (47.5%) followed by mild to moderate burden 45 (37.5%) and only 7 (5.8%) of the caregivers perceived severe burden during the study which was found to be statistically significant.

Conclusions:
This study highlighted the fact that although most of the caregivers perceived moderate to severe burden while caring a child with ASD. The degree of burden significantly correlated with the level of ASD in the child.
Prevalence and difference of COVID-19 symptoms, post-COVID conditions and duration of illness among the vaccinated and unvaccinated population: a cross-sectional study in Peshawar
Authors: Rahman Asad , Ikram Muhammad T. , Arif Amina , Khan Bakht D. , Azam Kamal U. , Fida Muhammad Sanaan , Rahim Adam K. , Khan Muhammad S. , Mushtaq Muhammad H. , Fida Raiyan , Yunus Hamza , Khan Mohammad D. 
Published: April 2023

Background:Studies on coronavirus disease 2019 (COVID-19) symptoms, post-coronavirus disease (COVID) conditions, and vaccination outcomes in Pakistan are limited and inconsistent. The study investigated differences in symptoms and post-COVID conditions between vaccinated and unvaccinated individuals and the impact of vaccination on illness duration based on existing literature.Methods:The study was a 3-month cross-sectional study conducted in Peshawar, Pakistan. It targeted individuals aged 16 and above who had contracted COVID-19 at least once during the recent pandemic, regardless of gender, and confirmed through reverse transcriptase polymerase chain reaction testing. The sample size was 250, determined using the WHO sample size calculator. Data were collected through questionnaires after obtaining verbal consent and analyzed using IBM SPSS version 26, taking into account their vaccination status along with other important variables.Results:Among the 250 respondents, 143 (57.2%) were unvaccinated, while 107 (42.8%) were vaccinated at the time of contracting COVID-19. Unvaccinated subjects developed a greater variety of symptoms that lasted for longer durations (P<0.001) with symptoms like dyspnea [55 (38.5%,P=0.011)], anosmia [76 (53.1%,P=0.001)], and chest pain [24 (16.8%,P=0.029)] occurring at greater percentages. Sixty-one (42.7%) unvaccinated subjects reported post-COVID conditions as opposed to 29 (27.1%) among the vaccinated group [P=0.011; odds ratio (OR)=0.5; 95% CI=0.29–0.86].Conclusion:The study found that COVID-19 vaccination can reduce the duration and frequency of symptoms, as well as post-COVID conditions. This is the first research of its kind conducted in Peshawar, Pakistan, and may serve as a foundation for future research in this demographic.
Factors associated with anemia among pregnant women attended antenatal care: a health facility-based cross-sectional study
Authors: Balcha Wondu F. , Eteffa Tola , Tesfu Azimeraw A. , Alemayehu Bezawit A. , Chekole Fentahun A. , Ayenew Asteray A. , Gessesse Nigusu A. , Getu Alemwork A. , Kassahun Eden A. , Gezahegn Tigist W. , Adugna Kebede F. , Nega Amanuel T. 
Published: April 2023

Introduction:Anemia is characterized by a decline in the number or size of red blood cells and Hb concentration, which results in impairment capacity to transport oxygen. It is a major cause of indirect maternal mortality. Anemia is largely preventable and easily treatable, if detected in time; however, it remains one of the leading causes of maternal morbidity and mortality, especially in developing countries. This study aimed to assess factors associated with anemia among pregnant women who attended antenatal care.Methods:A health facility-based cross-sectional study was conducted from 1 February 2020 to 2 March 2020 among 420 pregnant women. The data were collected by systematic random sampling technique, entered into a computer using EpiData 3.5, and analyzed using the Statistical Package of Social Sciences 23.0 version. Bivariate and multivariable logistic regression analyses were done to estimate the crude and adjusted odds ratio with a CI of 95% and aP-value of less than 0.05 considered statistically significant. Frequency tables, figures, and descriptive summaries were used to describe the study variables.Results:The overall prevalence of anemia was 32.9% (95% CI: 28.6–37.4), and it was higher in rural than urban pregnant women (45 vs. 23%), respectively. In multivariable analysis women who are found in the age group of greater than or equal to 30 years (AOR=3.45, 95% CI=1.22–9.78), rural residency (AOR=3.51, 95% CI=1.92–6.42), low family income (AOR=3.10, 95% CI=1.19–8.08), multiparty (AOR=2.91, 95% CI=1.33–6.38), a short interpregnancy gap (AOR 3.32, 95% CI=1.69–6.53), not taking iron and folate (AOR=4.83, 95% CI=2.62–9.90), third trimester of pregnancy (AOR=3.21, 95% CI=1.25–8.25), poor minimum dietary diversity score (AOR=3.54, 95% CI=1.58–7.95), undernourished (AOR=4.9, 95% CI=2.19–7.64), poor knowledge of anemia (AOR=3.19, 95% CI=1.72–5.93), consumption of coffee always after meal per day (AOR=3.24, 95% CI=1.42–7.42), having a history of irregular menstruation, and antepartum hemorrhage were significantly associated with anemia in pregnant women.Conclusion:This study showed that the prevalence of anemia in pregnant women in this study area was a moderate public health problem. The author suggest emphasizing the education and counseling of women on the advantage of taking the supplemented iron and folic acid. Health care providers should have to advise women to stay for at least 2 years before the next pregnancy to reduce the risk of adverse maternal and infant outcomes. Awareness creation in the community on the utilization of insecticide-treated bed nets is also needed.
High-dose intravenous versus low-dose oral vitamin C in burn care: potential protective effects in the severely burned: a retrospective cohort study
Authors: Malkoc Aldin , Jong Seungwon , Fine Kerry , Wong David T. 
Published: April 2023

Background:
Antioxidant therapies, such as ascorbic acid may have an important role during the acute phase of burn management. However, there are mixed results on the most effective dose and method of administration of ascorbic acid in burn patients. In this study, we compared the efficacy of intravenously and orally administered ascorbic acid in second-degree burns greater than 20% total-body-surface-area.

Materials and methods:
The hospital burn database was used to obtain data on all patients with second-degree or deeper burns of 20% total-body-surface-area or greater. Fourteen patients were selected at random to receive a scheduled dose of 1250 mg intravenous ascorbic acid every 6 h for 72 h. This was considered the high-dose group. During same period, 40 patients received scheduled 500 mg oral ascorbic acid every 6 h for 72 h and this was considered the low-dose group. We gathered sociodemographic and clinical variables associated with ascorbic acid dosing.

Results:
In our study, statistically significant variables were fluid requirements (p<0.001), hospital stay (p=0.011), length of time intubated on ventilator (p<0.001), colloids used (p=0.002), and total procedures required (p=0.014). Despite higher modified Baux predicted mortality in the high-dose group (10 patients vs. 24 patients, p=0.026) there was no noted significant association in days until the first infection and mortality rate (p=0.451 and 0.326, respectively).

Conclusions:
The calculated modified Baux predicted a higher mortality rate with the higher dosing group, yet this study did not find a mortality difference between the groups. We speculate that high-dose intravenous ascorbic acid may have protective effects in burn resuscitation. This finding may support some previous studies that found that high-dose ascorbic acid may improve clinical outcomes.