bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute limb ischemia from embolization of left ventricular pseudoaneurysm thrombus: a rare case report
Authors: Ismayl Mahmoud , Radaideh Qais , Abusnina Waiel , Aboeata Ahmed , Holmberg Jeffrey 
Published: April 2023

Introduction and importance:
Myocardial infarction (MI) can lead to a wide spectrum of mechanical complications. Left ventricular pseudoaneurysm (LVP) is a rare but serious complication of MI.

Case presentation:
A 69-year-old woman with prior coronary artery bypass grafting and a remote history of inferolateral ST-elevation MI (STEMI) with failure to revascularize the left circumflex artery presented with gangrenous right toes that appeared 2 years after her STEMI. A computed tomography angiogram of the right lower extremity showed arterial occlusion and mild atherosclerotic disease. Echocardiography revealed a pseudoaneurysm with an adherent mural thrombus as the underlying cause of acute limb ischemia. The patient was started on heparin and cardiothoracic surgery was consulted but did not operate as the risk of surgery outweighed the benefit. On hospital day 3, the patient underwent amputation of her gangrenous toes as the tissue was nonviable. The patient remained stable during her hospital stay and was discharged on day 5 on long-term anticoagulation.

Clinical discussion:
LVPs have a wide spectrum of presentations, from asymptomatic or nonspecific symptoms to thromboembolism with end-organ damage, such as in our case. Therefore, early diagnosis and management are of paramount importance. Our patient’s prior coronary artery bypass grafting most likely helped in forming a fibrous pericardium that sealed the pseudoaneurysm and prevented its rupture.

Conclusions:
STEMI requires close follow-up, especially in cases where revascularization is not achievable, as the risk of mechanical complications and mortality is high. Physicians should have a high suspicion for LVP in patients with prior MI, given its wide spectrum of presentations.
Accidental gunshot injury with left-sided lung injury and D11 burst fracture: a case report
Authors: Chaudhary Aashutosh , Acharya Suyash , Pradhan Shiris K. , Gurung Kalpana , Karmacharya Robin Man , Vaidya Satish , Mahat Chadani , Kunwar Kajol , Bhatt Swechha 
Published: April 2023

Introduction:
Penetrating chest injuries are mainly caused by gunshot trauma and stab injuries. These lead to damage to the vital structures, which requires a multidisciplinary approach for management.

Case presentation:
We present a case of an accidental gunshot injury (GSI) to the chest resulting in left-sided hemopneumothorax, left lung contusion, and D11 burst fracture with spinal cord injury. The patient underwent thoracotomy to remove the bullet along with instrumentation and fixation of the D11 burst fracture.

Clinical discussion:
Penetrating trauma to the chest requires prompt resuscitation and stabilization with eventual definitive care. Most GSIs to the chest require chest tube insertion, which helps to create negative pressure in the chest cavity, allowing adequate time for the expansion of the lungs.

Conclusion:
GSIs to the chest could give rise to life-threatening conditions. However, the patient must be stabilized for at least 48 h before performing any surgical repair to ensure that there are fewer complications following surgery.
An interesting case of pulmonary hypertension in nephrotic syndrome due to amphetamine use for attention-deficit hyperactivity disorder
Authors: Khan Abat , Ubaid Aamer , Hanif Muhammad , Jaiswal Vikash , Gohar Ashraf , Mehta Aashna , Ramakrishnan Dushyant , Shrestha Abhigan Babu 
Published: April 2023

Introduction and importance:
Pulmonary arterial hypertension (PAH) was first associated with stimulants use in the 1960s during an outbreak of amphetamine-like appetite suppressants (anorexigens). To date, various drugs and toxins have been correlated with PAH. Diagnosing PAH in nephrotic syndrome has always remained a challenge due to the overlap of signs and symptoms in clinical presentation between the two entities.

Case presentation:
In this report, the authors present an interesting case of a 43-year-old male, diagnosed with nephrotic syndrome secondary to minimal change disease, as well as currently presenting with PAH secondary to amphetamine.

Clinical discussion and conclusion:
Patients with nephrotic syndrome and end-stage renal disease should be regularly followed up and evaluated for comorbidities, complications, as well as adverse events from pharmacological intervention. In patients with end-stage renal disease hypertension control is key, stimulant use can precipitate poor blood pressure control especially in pulmonary arteries resulting in PAH. PAH can result in right ventricular dysfunction and heart failure that can further exacerbate renal dysfunction and vice-versa in a vicious cycle, deteriorating patient condition and quality of life.
Spontaneous facial hematoma induced by vitamin K antagonist therapy: a rare case report
Authors: Mrabet Asmae , Boulouiz Soumiya , Bilal Marwa , El Ouafi Nouha , Bazid Zakaria 
Published: April 2023

Introduction and Importance:
The benefits of anti-vitamin K drugs have been demonstrated in several indications; however, it is always counterbalanced by an increased risk of bleeding, that can occur in different areas. Facial hematoma is a rare bleeding complication to our knowledge, this is the first report of a rapidly expanding atraumatic facial hematoma secondary to vitamin K antagonist over coagulation.

Case Presentation:
The authors report the case of an 80-year-old woman with a medical history of hypertension, and pulmonary embolism after 15 days of immobilization following a hip fracture treated surgically 3 years earlier, who has been on vitamin K antagonist therapy since then, without any follow-up, came into our emergency department complaining of a sudden onset of progressive left facial swelling for one day, and vision loss in her left eye. Her blood investigations revealed a high international normalized ratio of prothrombin up to 10. A computed tomography scan exposing face, orbit, and oromaxillofacial area objectived spontaneously hyperdense collection in the left masticator space suggestive of an hematoma. An intraoral incision was done by oromaxillar surgeons, and drainage were performed with a favorable evolution.

Clinical Discussion
In this mini review, the authors aim to describe this rare complication and to insist on the necessity of regular follow-up with international normalized ratio values and early warning signs of bleeding to prevent such fatal complications.

Conclusion:
Immediate recognition and management of such complication is very important to avoid complications.
The capillary-leakage syndrome caused by glyphosate poisoning: a case report
Authors: Ge Xiaogang , Yang Zhihui , Cai Qiqi 
Published: April 2023

Background, introduction, and importance:
Glyphosate is widely used in agriculture even though it can cause self-poisoning, inducing gastrointestinal disturbance, acute respiratory distress syndrome, arrhythmia, renal failure, and even death.

Case presentation:
The authors present a case of glyphosate poisoning in a patient who developed capillary-leak syndrome, severe metabolic acidosis, and shock. After treatment with hemoperfusion and continuous renal replacement therapy, the patient was extubated after 7 days and transferred out of the intensive care unit after 10 days.

Clinical discussion:
Severe glyphosate poisoning can lead to multiple organ failure and systemic capillary leak syndrome. Clinical manifestations of systemic capillary leak syndrome included hemoconcentration, increased hematocrit, hypoalbuminemia, interstitial fluid accumulation, and refractory hypotension. Substantial improvement of capillary leakage was observed only gradually after initiation of early continuous renal replacement therapy, plasma infusion, and application of ulinastatin.

Conclusions:
This case report highlights the life-threatening nature of glyphosate poisoning. Aggressive treatment and careful monitoring of complications are required, particularly in patients at risk of capillary leakage syndrome.
Outcomes of pancreas transplantation in patients with underlying inflammatory bowel disease: a retrospective case series
Authors: Ray Samrat , Yousuf Anila , Dharia Atit , Ayoub Ghassan , Parmentier Catherine , Norgate Andrea , Schiff Jeffrey , Shwaartz Chaya , Selzner Markus , Reichman Trevor W. 
Published: April 2023

Introduction:
Despite having emerged as a definitive treatment for diabetes mellitus (DM), pancreas transplantation remains a formidable surgical task owing to complications like graft pancreatitis, enteric leaks, and rejection. This becomes more challenging in the setting of underlying bowel pathology, such as inflammatory bowel disease (IBD), which has a strong immune-genomic association of co-existence with DM. Risk of anastomotic leaks, dose adjustments of immunosuppressants and biologicals, and management of IBD flares constitute some of the major perioperative challenges calling for a protocol-based, systematic, multidisciplinary approach.

Patients and methods:
This was a retrospective case series of patients between January 1996 and July 2021, with all patients being followed up until December 2021. All consecutive patients with end-stage DM who underwent pancreas transplantation (alone, simultaneous with kidney transplantation or after kidney transplantation) and had pre-existing IBD were included in the study. A Comparison of 1-, 5-, 10-year survival was done with pancreas transplant recipients without underlying IBD using Kaplan–Meir curves.

Results:
Of the total 630 pancreas transplants performed between 1996 and 2021, eight patients had IBD, mostly Crohn’s disease. Following pancreas transplantation, two of the eight patients had duodenal leaks, with one a requiring graft pancreatectomy. The 5-year graft survival rate for the cohort was 75% compared to 81.6% for the overall cohort of patients undergoing pancreas transplantation (P=0.48) with a median graft survival of 48.4 months compared to 68.1 months in the latter (P=0.56).

Conclusion:
The findings of the series provide a snapshot of the outcome of pancreas transplantation in the background of IBD, suggesting a graft and overall patient survival rates comparable with pancreas transplantation in patients without underlying IBD, with further validation of the findings required in a larger cohort of patients in the future.
Evaluation of human growth hormone (somatropin) in socket healing: a split-mouth randomized controlled trial
Authors: Sleman Nadim , Khalil Ali 
Published: April 2023

Purpose:
Techniques for preserving alveolar bone after tooth extraction are becoming a part of the usual clinical practice of clinicians. These techniques aim at minimizing postextraction bony resorption, hence, minimizing subsequent follow-up for implant insertion. This randomized clinical study aimed to measure and compare alveolar bone and soft tissue healing between extraction sockets treated with somatropin to untreated sockets.

Methods:
The study is designed as a split-mouth randomized clinical trial. The selected patients were indicated for bilateral symmetrical tooth extraction, where each patient had an indication to extract two symmetrical teeth in anatomy and number of roots. Somatropin was applied to the tooth socket of the randomly selected side after tooth extraction by gel foam, and the control side was filled with gel foam only. A clinical follow-up of the soft tissue was done 7 days after tooth extraction to evaluate clinical aspects of the healing process. Radiographic follow-up was performed using a cone-beam computed tomography scan to assess volumetric changes of alveolar bone in the extraction area prior to and 3 months after the surgical procedure.

Results:
A total of 23 patients (aged 29.1±9.5 years) participated. The results showed a statistically significant association between somatropin application and better preservation of the bony dimensions of the alveolar ridge. Bone loss was −0.691±0.628 mm for the buccal plate on the study side compared to −2.008±1.175 mm on the control side. The level of the lingual/palatal plate bone loss was −1.052±0.855 mm on the study side compared to −2.695±1.878 mm on the control side. The bone loss of alveolar width was −1.626±1.061 mm on the study side compared to −3.247±1.543 mm on the control side. The results also showed better healing of covering soft tissues (P<0.05), as well as bone density in the socket where somatropin was applied, which has been statistically significant.

Conclusion:
The data from this study demonstrated that the application of somatropin in tooth sockets postextraction showed an effective contribution to reducing alveolar bone resorption and improving bone density following extraction, in addition to better healing of covering soft tissue.
Immunohistochemical study of insulin-like growth factor 1 in calcifying epithelial odontogenic tumor and ameloblastoma: experimental research
Authors: Alkutaifan Haya , Alnour Amirah , Almohareb Mumdouh 
Published: April 2023

Background and aim of the study:
Several studies have indicated that increased levels of insulin-like growth factor 1 (IGF-I) or altered levels of its binding proteins are associated with an increased risk of the most common cancers, including cancers of the colorectal, lung, breast and prostate. The aim of this study is to investigate the expression of IGF-1 in both calcifying epithelial odontogenic tumor (CEOT) and ameloblastoma.

Materials and methods:
The research sample consisted of 23 paraffin block from Oral Pathology Department, Faculty of Dentistry, Damascus University, including six biopsies of CEOT, two biopsies of the plexiform ameloblastoma and 14 biopsies of the follicular ameloblastoma. All specimen were prepared and immunostained with rabbit polyclonal antibody to IGF-1. Immunostaining was assessed according to German-semiquantitative scoring system, and then the results were aggregated and statistically analyzed using SPSS version 13.0 (Student’s test for two independent samples, one-way analysis of variance, Kruskal–Wallis test and Mann–Whitney U-test), the significance level P value less than 0.05 was considered statistically significant.

Results:
All CEOT and ameloblastoma samples were positive for IGF-1 staining, except one sample of ameloblastoma, which was negative. The results showed that there were no statistically significant differences between CEOT and ameloblastoma in the values of IGF-1 expression (P=0.993) and IGF-1 expression rates (P=0.874) and in the frequency of IGF-1 expression (P=0.761) and IGF-1 staining intensity score (P=0.731).

Conclusion:
IGF-1 plays an important role in the growth of odontogenic tumors and there are no differences in IGF-1 expression between CEOT and ameloblastoma.
Levels of SARS-COV-2 anti-spike protein receptor-binding domain (S-RBD) IgG in Indonesian-vaccinated healthcare workers: experimental research
Authors: Tambunan Betty A. , Ugrasena I. Dewa G. , Nugraha Jusak , Fitriah Munawaroh , Permatasari Cynthia A. , Moses Emmanuel J. , Yusoff Narazah M. , Aryati  
Published: April 2023

Introduction:
Studies evaluating the levels of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) anti-spike protein receptor-binding domain (S-RBD) immunoglobulin G (IgG) antibodies in vaccinated healthcare workers in Indonesia are limited.

Objectives:
Evaluating time-dependent levels of anti-IgG S-RBD antibodies and monitoring the response of healthcare workers in a tertiary hospital in Indonesia after vaccination.

Materials and methods:
This prospective cohort observational study was conducted from January to December 2021. A total of 50 healthcare workers participated in the study. Blood samples were collected at five time points. Antibody levels were measured using a CL 1000i analyzer (Mindray Bio-Medical Electronics Co., Ltd., Shenzhen, China). Antibody levels between groups were analyzed using the Wilcoxon signed-rank test with P less than 0.05.

Results:
The median levels of SARS-CoV-2 anti-S-RBD IgG antibody on days 14, 28, 90, and 180 were significantly higher than the levels on day 0 (P<0.001). After the second dose, peak levels were observed on day 14; the levels decreased gradually after day 28. Despite receiving two doses of the vaccine, 10 out of 50 participants (20%) were infected with COVID-19 (coronavirus disease 2019). However, symptoms were mild, and antibody levels were significantly higher than in noninfected participants (P<0.001).

Conclusion:
SARS-CoV-2 anti-S-RBD IgG antibody levels increased significantly until day 14 after the second dose; the levels decreased gradually after day 28. Ten participants (20%) were infected with SARS-CoV-2, with mild symptoms.
Differences in BMI obesity measures in a workers compensation population: a cross-sectional study
Authors: Hyman Mark H. , Peled Tamra J. , Hyman Noah M. , Tan Jingyi , Guo Xiuqing , Rotter Jerome I. 
Published: April 2023

Objective:
To assess the accuracy of BMI compared to directly measured dual-energy X-ray absorptiometry percent body fat (DEXA %BF) among a worker compensation population.

Methods:
The agreement between BMI and DEXA %BF was assessed by the Pearson correlation coefficient among 1394 evaluable patients over a 5-year period. Sensitivity and specificity were calculated to measure how well BMI can identify true obese and nonobese individuals.

Results:
Using at least 30kg/m2 to identify obesity, BNI had a specificity of 0.658 and a sensitivity of 0.735. The correlation was better in females at 0.66, compared to males at 0.55, and weaker in older age groups at 0.42, as compared to the youngest age group at 0.59. Overall, 29.8% of the population was reclassified based on their DEXA %BF measures.

Conclusions:
In a 5-year cohort worker compensation population, BMI was an inaccurate measure of true obesity.
Knowledge and attitude toward COVID-19 booster dose among health care professionals in Nepal: a cross-sectional study
Authors: Paudel Kiran , Shah Sangam , Bhusal Sandesh , Dahal Krishna , Bhatta Nikita , Pokhrel Saurav , Dahal Suman , Gaihre Milan , Mudvari Anish , Gyanwali Pradip 
Published: April 2023

Introduction:
Vaccination has become the most effective way to combat the coronavirus disease 2019 (COVID-19) pandemic. As there have been reports of a gradual decline in the protection it offers, many countries have decided to administer booster doses of the COVID-19 vaccine. In Nepal, booster doses have been introduced to frontline health workers as a priority group. Therefore, this study aims to assess the knowledge and attitude of health care professionals toward booster doses of COVID-19 vaccines in Nepal.

Methods:
A cross-sectional study was conducted from December 2021 to January 2022 among health care professionals working at public health facilities in Nepal. Multivariable logistic regression was performed to identify predictors that correlate with knowledge and attitude toward COVID-19 booster dose. P value less than 0.05 was considered statistically significant.

Results:
A total of 300 participants were included in the final analysis. Among the study participants, 68.0% and 78.6% had good knowledge and favorable attitude toward COVID-19 booster dose, respectively. Female health care workers and those who had received a single dose of COVID-19 vaccine had significantly lower odds of having good knowledge of COVID-19 booster dose. Similarly, participants with lower educational levels and those who had received a single dose of COVID-19 vaccination had an unfavorable attitude toward COVID-19 booster dose.

Conclusion:
This study showed a satisfactory level of knowledge and attitude of health care professionals toward COVID-19 booster dose in Nepal. Health care professionals’ positive attitude toward COVID-19 booster dose vaccine is key to the patient and community safety. Personalized education and risk communication can aid in improving overall awareness and attitudes toward COVID-19 booster dose in such populations.
Perioperative mortality and its predictors among patients undergoing emergency laparotomy at selected southern Ethiopian governmental hospitals, 2022: a multicenter prospective cohort study
Authors: Hailu Seyoum , Ayinie Animut , Amsalu Hunde , Hailu Sileshi , Tadesse Muhiddin , Mamo Temesgen , Sagni Yonas , Mekonen Semagn , Jemal Bedru 
Published: April 2023

Background:
Globally, emergency laparotomy is a frequently performed type of surgery with high morbidity and mortality rates, even in the best healthcare systems. There is limited knowledge regarding the outcome of emergency laparotomy performed in Ethiopia.

Objective:
To assess perioperative mortality and its predictors among patients undergoing emergency laparotomy at selected southern Ethiopian governmental hospitals.

Methods:
A multicenter prospective cohort study was conducted, and data were collected at selected hospitals after obtaining ethical approval from the Institutional Review Board. Data were analyzed using SPSS version 26.

Results:
The rate of postoperative complications after emergency laparotomy surgery was 39.3%, with an in-hospital mortality rate of 8.4% and a length of hospital stay of 9±6.5 days. The predictors of postoperative mortality were the age of the patient greater than 65 [adjusted odds ratio (AOR)=8.46, 95% CI=1.3–57.1], presence of intraoperative complications (AOR=7.26, 95% CI=1.3–41.3), and postoperative ICU admission (AOR=8.5, 95% CI=1.5–49.6).

Conclusion:
Our study revealed a significant level of postoperative complications and in-hospital mortality. The identified predictors should be sorted and applied to the preoperative optimization, risk assessment, and standardization of effective postoperative care following emergency laparotomy.
Health-related quality of life measured by SF-36 among postdelivery mothers attending maternal and child health clinic in Eastern Nepal: a cross-sectional study
Authors: Chapagain Pratiksha , Pyakurel Prajjwal , Anand Ayush , Gupta Ashwini , Subedi Durga 
Published: April 2023

Objectives:
Assessing health-related quality of life (HRQoL) and its associated factors is essential for providing adequate healthcare and developing necessary interventions in women postdelivery. This study intended to find out the HRQoL score and related factors among women postdelivery in Nepal.

Methodology:
This was a cross-sectional study using nonprobability sampling conducted at a Maternal and Child Health (MCH) Clinic in Nepal. The study participants were 129 women postdelivery to 12 months who visited the MCH Clinic from 2 September 2018 to 28 September 2018. Outcome measures were sociodemographic, clinical indicators, obstetric indicators, and their relation with the overall HRQoL score of postdelivery mothers using the Short Form Health Survey (SF-36) Version 1.

Results:
Of 129 respondents, 68.22% were in the 21–30 age group, 36.43% were upper caste, 88.37% were Hindu, 87.60% were literate, 81.39% were homemakers, 53.49% with income less than 12 months, 88.37% had family support, and 50.39% with vaginal deliveries. HRQoL was significantly more in employed women (P=0.037), those with family support (P=0.003), and those who had a cesarean section (P=0.02) and wanted pregnancy (P=0.040).

Conclusion:
HRQoL in women postdelivery can be influenced by employment status, family support, type of delivery, and desirability of pregnancy.