bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interleukin-6 and tumor necrosis factor-α levels in tear film of Keratoconus patients
Authors: Peyman Alireza , Namgar Mohammad , Feizi Awat , Hakemi Mazdak Ganjalikhani , Nasab Fahimeh Hosseini , Pourazizi Mohsen 
Published: August 2023

Background:
It is hypothesized that increased inflammatory markers in keratoconus (KC) may be one of the causes of corneal damage. The aim of our study was to the measurement of tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL)-6 in tear of patients with KC and investigate their relationship with the severity of KC.

Materials and Methods:
The current study was performed on KC patients and healthy controls with a case-control setting. Tear levels of TNF-α and IL-6 were measured after collecting the tears from the tear lake using a filter paper via Schirmer I method without anesthesia.

Results:
Eighty-one KC patients (mean age 29.45 ± 5.06 years) and 85 controls (mean age 28.01 ± 5.14 years) were enrolled. The mean levels of IL-6 and TNF-α were 26.77 ± 8.16, and 34.58 ± 9.82 pg/ml in the healthy group and 103.22 ± 51.94, and 183.76 ± 54.61 pg/ml in the KC group, respectively (P < 0.001). There was a significant relationship between the severity of the KC and the mean levels of IL-6 TNF-α in the case group (P < 0.001).

Conclusion:
Our results indicated that the mean levels of IL-6 and TNF-α are significantly higher in KC than the healthy group, and the disease severity was significantly associated with TNF-α and IL-6.
Quality of life and its determinants in patients with noncystic fibrosis bronchiectasis
Authors: Sami Ramin , Zohal Mohammadali , Khanali Fatemeh , Esmailzadehha Neda 
Published: August 2023

Background:
Promoting quality of life (QoL) in patients with bronchiectasis, as a chronic disease, is a part of therapeutic principles. This study aimed to investigate QoL and its determinants in patients with noncystic fibrosis (CF) bronchiectasis.

Materials and Methods:
This cross-sectional study was conducted on 62 patients (38.7% male, mean age: 44) with non-CF bronchiectasis and involvement of ≥2 lobes in Qazvin, Iran. QoL was evaluated using the St. George's Respiratory Questionnaire (SGRQ). The relationships of QoL subscales with clinical (cough, dyspnea, and sputum volume) and paraclinical (spirometry, computerized tomography scan, sputum microbiology, and 6-min walk test [6-MWT]) were assessed using Pearson's correlation coefficient and multiple linear regression analyses.

Results:
The mean SGRQ total score was 53.1 (standard deviation 19.8) out of 100. The level of dyspnea (r = 0.543, P < 0.001), cough (r = −0.594, P < 0.001), 6-MWT (r = −0.520, P < 0.001), sputum volume (r = 0.423, P = 0.002), and number of exacerbations (r = 0.446, P = 0.009) had significant correlation with SGRQ total score. In multiple regression analysis, forced expiratory volume in 1 s was an independent predictor of the symptom (β = −0.22, P = 0.048) and activity (β = −0.43, P = 0.03) subscales, whereas cough was an independent predictor of the symptom subscale (β = −2.1, P = 0.002).

Conclusion:
In patients with non-CF bronchiectasis, the extent of lung impairment has a lower effect on the QoL than clinical symptoms. It seems that the QoL can be improved through the proper treatment of clinical symptoms and rehabilitation for promoting 6-MWT.
Pattern of Metastasis of Head and Neck Cancer in Nigeria: A 10 Year Review
Authors: Okwor VC , Folasire A , Ntekim AI , Okwor CJ , Nwankwo KC , Arua SC 
Published: August 2023

ABSTRACT

Introduction:
Head and neck cancer is a common and aggressive malignancy with a high morbidity and mortality profile that occur in several anatomical sites in the head and neck region. They constitute the tenth most common cancer in the world. Metastatic head and neck cancers are associated with severe morbidities and its treatment is mainly palliative. This study examined the patterns of metastases of head and neck cancer in patients in a tertiary hospital in Nigeria.

Method:
The data extraction form was used to obtain information from the Radiotherapy treatments records and the case notes of patients with histological diagnosis of Head and Neck Cancers between 2002 and 2011 at the Radiotherapy department, University College Hospital, Ibadan. Analyses was done using statistical Package for Social Sciences (SPSS) Version 20.0.

Results:
A total of 481 patients were seen in this study. The age of the patients ranged from 11 years to 80 years with mean age of 42 years. The male to female ratio was 2:1. The peak age of incidence was between 40-49 years. Most patients presented with stage III and IV. Nasopharyngeal carcinoma had the highest proportion of occurrence 205 (42.6%) followed by paranasal sinuses. Lung had the commonest site of metastasis followed by bones.

Conclusion:
More than half of the patients presented late with the commonest cancer being nasopharyngeal carcinoma. Lung was the commonest site of distant metastasis with nasopharyngeal carcinoma having the highest proportion of metastasis to the lungs at two years follow up.
The Feasibility of Introducing Early Pregnancy Assessment Unit in Nigerian Hospitals: A Pilot Study from a Private Hospital in Enugu, Southeast Nigeria
Authors: Ugwu GO , Iyoke CA , Nnagbo JE 
Published: August 2023

ABSTRACT

Background:
Early pregnancy assessment unit (EPAU) is a dedicated unit that provides specialist care such as definitive ultrasonographic and biochemical assessment to women who have or have had vaginal bleeding or pain before 16 weeks of pregnancy. Such patients usually have a positive pregnancy test with a scan showing pregnancy of an unknown location, previous ectopic pregnancy, recurrent miscarriages, or previous molar pregnancy. Such a holistic and prompt approach leads to better outcome in the management of women with early pregnancy and other complications.

Aim:
This study aimed to describe the diagnosis and outcome of early pregnancy pain and bleeding, managed by rapid ultrasonographic and biochemical assessments by a dedicated gynecological team in a private hospital to determine the feasibility of establishing early pregnancy assessment units (EPAUs) in Nigeria.

Materials and Methods:
This is a cross-sectional study of eligible cases of early pregnancy bleeding and pain in a private gynecological hospital in Enugu, Nigeria.

Results:
During the 9-year study period, 160 women with early pregnancy pain or bleeding were analyzed. The mean age of the participants was 32.3 ± 7.2 years, and they were mostly multipara (68.7%) and Christians and of the Igbo tribe (91.3%). The final diagnosis after clinical and radiological evaluations showed that the majority had miscarriages (82.5%), while 17.5% had ectopic gestations. All the participants had their definitive diagnosis and treatment within 24 hours of presentation. There was no recorded case of maternal death.

Conclusion:
EPAUs are feasible in a Nigerian setting provided that trained, dedicated staff and equipment are provided.
Prognostic Role of Optic Nerve Sheath Diameter in Stroke in Emergency Department, A Case Control Study
Authors: Batur A , Karaca MA , Arslan V , Boz M , Ibrahimov Z , Erbil B , Onur MR 
Published: August 2023

ABSTRACT

Background:
Sonographic measurement of optic nerve sheath diameter (ONSD) can reflect intracranial pressure (ICP) indirectly and determine the neurology intensive care unit (NICU) requirement and mortality in acute ischemic stroke (AIS).

Aim:
To demonstrate the effectiveness of ONSD to determine mortality, morbidity, and NICU requirement on patients with the AIS.

Methods:
The sonographic ONSD measurements were performed on each patient with AIS, over 18 years old. All patients were categorized according to the Oxfordshire Community Stroke Project (OCSP) classification system. MRI images were examined for increased ICP, and the patients were categorized into two groups as increased ICP (i-ICP) and normal ICP. The ONSD results were evaluated in terms of classifications, outcomes, and prognosis of the patients.

Results:
One hundred and five patients were included and 31 (35.2%) were in the i-ICP group. The median ONSDs were 5.26 mm in the i-ICP group and 4.62 mm in the normal ICP group (P < 0.001). The median ONSDs were 5.13 mm in the NICU group and 4.69 mm in the neurology ward (NW) group (P = 0.001). The total anterior circulation infarction (TACI) subgroup had higher ONSDs than the others (TACI: 5.27 mm; PACI: 4.73 mm; POCI: 4.77 mm; and LACI: 4.64 mm, P < 0.001). The NICU requirements were higher in the TACI subgroup. The median ONSD was 5.42 mm in the deceased group (survived: 4.77 mm, P < 0.001).

Conclusion:
ONSD may be favorable for predicting the increased ICP and the NICU requirement in OCSP subgroups. Moreover, ONSD can be used to foresee the mortality of AIS.
Is Endometrial Sampler SAP-1 a Good Way to Diagnose the Common Intrauterine Occupying Lesions?—A Diagnostic Study
Authors: Hong Y 
Published: August 2023

ABSTRACT

Background:
Intrauterine occupying lesion is clinically common in the female reproductive organs. Endometrial cancer is the most critical one among intrauterine occupying lesions, which accordingly is considered as the main indication for endometrial cancer screening, for which endometrial sampler SAP-1 was recommended as an effective sampling tool.

Objective:
This study aimed to evaluate the diagnostic efficacy of SAP-1 for endometrial polyp and uterine submucous myoma.

Materials and Methods:
From August 2018 to June 2022, patients who were hospitalized for undergoing hysteroscopy examination were enrolled in this study. Before the procedure, endometrial samples were collected by the method of SAP-1. The histological results were compared with those by hysteroscopy sampling to analyze the diagnostic efficacy of SAP-1.

Results:
The qualified rate for the SAP-1 sampling was 92.1%, which is a bit lower than that by method of hysteroscopy (95.3%). And the difference was not statistically significant (P > 0.05). Endometrial polyp (47.5%) and uterine submucous myoma (7.1%) accounted for the majority of endometrial lesions, while only 11.3% endometrial polyps (17/151) and 0% submucous myomas (0/23) were detected by SAP-1 sampling.

Conclusion:
Endometrial sampler SAP-1 is not effective in detection of solid intrauterine lesions indicated by the imaging examination. Hysteroscopy is recommended for definite diagnosis.
Changing Pattern of Cancer Distribution: Experience From a Tertiary Health Institution in Nigeria and Review of Literature
Authors: Adeniji KA , Folaranmi OO , Odetunde OA , Adegboye O , Ibiyeye KM , Ighodalo JE , Olayiwola IO , Suleiman KA , Abubakar-Akanbi SK 
Published: August 2023

ABSTRACT

Background:
Over the years, epidemiological surveys have established that the five leading cancers in Africa (in descending order of prevalence) are cancers of the breast, cervix, prostate, liver, and colorectum.[1] However, a 10-year retrospective review of cases performed at the University of Ilorin Teaching Hospital (UITH) revealed some changes in the cancer incidence pattern in this region.

Aims:
The aim of the study was to determine the distribution of cancers managed at the UITH, a tertiary health care center in North Central Nigeria, in the past 10 years and create awareness of changing cancer prevalence patterns in this region.

Materials and Method:
This was a retrospective review of cancer epidemiology at UITH over a period of 10 years. Confirmed cancer cases within this period were extracted from the data in the Department of Anatomic Pathology and the Cancer registry. Descriptive and inferential statistics were applied to obtain rates and proportions for both sexes.

Results:
There were 2430 confirmed cases of cancer during the study period from January 2011 to December 2020. Out of these cases, 1310 (54%) were seen in females and 1120 (46%) were seen in males. The most common cancer recorded (in total) was prostate cancer, which accounted for 18% of all cases, constituting approximately one in six of all cancer cases. This was followed closely by breast cancer (16.6%). The most commonly diagnosed cancer in males was prostate cancer (four in ten cancer cases in males), whereas in females, it was breast cancer (approximately three in ten cancer cases in females). Cancers of the lungs and liver were rare in both sexes in this study. In children, the most common malignancies were retinoblastoma (38.3%), non-Hodgkin lymphomas (16.8%), and nephroblastoma (12.8%).

Conclusion:
There is a changing trend in cancer cases with some cancer cases now predominating compared to previous years. This may be because of increased awareness and/or better medical screening and diagnostic techniques.
Demographics of Tonsillar Hypertrophy among Sickle Cell Disease Patients in Calabar
Authors: Adekanye AG , Akaba K , Umana ANU , Mgbe RB , Francis PM , Okoi-Obuli J 
Published: August 2023

ABSTRACT

Background:
Sickle cell disease (SCD) is the most common genetic disorder, with Africa bearing the highest burden. In this cohort study, sickle cell subjects are immunocompromised and predisposed to recurrent infections and tonsillar hypertrophy, especially in children. Subsequently, tonsillar hypertrophy leads to sleep-disordered breathing (SDB) with resulting hypoxemia, hypercapnia, and acidosis, raising the risk of HbS polymerization and, consequently, vaso-occlusive phenomena and other complications.

Aims:
This study aimed to compare tonsillar hypertrophy between sickle cell patients and controls.

Materials and Methods:
A cross-sectional descriptive study was conducted at, University of Calabar Teaching Hospital, Calabar from September 2019 to September 2021. The cohort of the study was an SCD patient confirmed using hemoglobin electrophoresis at the hematology laboratory of University of Calaabr teaching hospital and recruited via the adult and pediatric hematology unit of University of Calabar teaching hospital, and Calabar sickle cell club. The data were analyzed using Microsoft Excel and IBM Statistical Package and Service Solution (SPSS) version 22.

Results:
Using Brodsky’s grading, the prevalence of grade 3 and 4 hypertrophic tonsils in sickle cell subjects was 41.6% but 17.3% in control. The age range of 0–25 years was the most frequently affected with the peak at 0–5 years. The males among the sickle cell subjects were slightly more affected than the females (M: F =1.2:1), while the females were slightly more in the control (M: F =1:1.1).

Conclusions:
Hypertrophic tonsils affect control and SCD, but the obstructive grades are commoner in genotypes SCD- Sickle cell disease Haemoglobin SS, SC and AA.
Willingness to Enroll and Pay for Community-Based Health Insurance, Decision Motives, and Associated Factors among Rural Households in Enugu State, Southeast Nigeria
Authors: Oluedo EM , Obikeze E , Nwankwo C , Okonronkwo I 
Published: August 2023

ABSTRACT

Background:
Over 70% of Nigeria’s population is poor and rural, and most lack financial risk protection against ill health. Community-based health insurance (CBHI) may be an essential intervention strategy for ensuring that quality healthcare reaches the informal and rural populations.

Aim:
This article explores the willingness to enroll (WTE) and willingness to pay (WTP) for CBHI by community members, their decision considerations, and associated factors in Enugu State, Nigeria.

Materials and Methods:
We adopted a cross-sectional survey design with a multi-stage sampling approach. A validated and pre-tested questionnaire was used to elicit information from the respondents. WTE and WTP for CBHI was determined using the bid contingent valuation method. A test of correlation/association (Chi-square and ordinary least square regression) was conducted to ascertain the relationship between WTP for CBHI and other variables at a 95% confidence interval. The socioeconomic status index was generated using principal component analysis. A test of association was conducted between the demographic characteristics and WTE and WTP variables.

Key Findings:
A total of 501 household heads or their representatives were included in the study which yielded a return rate of 98.2%. The finding showed that most (92.4%) of the respondents indicated a WTE in CBHI. 86.6% indicated a willingness to pay cash for CBHI, while 84.4% indicated a willingness to pay other household members for CBHI. There was a significant association between gender, marital status, education, location, and willingness to pay. The study shows that 81.6% of the respondent stated that qualified staff availability motivates their WTE/WTP for CBHI, while 78.1% would be willing to enroll and pay for CBHI if services were provided free, and 324 (74.6%) stated that proximity to a health facility would encourage them to enroll and pay for the CBHI.

Conclusion:
This community demand analysis shows that rural and peri-urban community members are open to using a contributory mechanism for their health care, raising the prospect of establishing CBHI. To achieve universal health coverage, policy measures need to be taken to promote participation, provide financial and non-financial incentives and ensure that the service delivery mechanism is affordable and accessible. Further studies are needed to explore ways to encourage participation and enrollment in CBHI and other contributory schemes among under-served populations and improve access to and utilization of healthcare services.
MESNA (2-Mercaptoethanesulfonate) Attenuates Brain, Heart, and Lung Injury Induced by Carotid Ischemia-Reperfusion in Rats
Authors: Mercan M , Şehirli AÖ , Gültekin Ç , Chukwunyere U , Sayıner S , Gençosman S , Çetinel Ş , Abacıoğlu N 
Published: August 2023

ABSTRACT

Background:
Ischemia-reperfusion (I/R) causes organ dysfunction as a result of the increased formation of various reactive oxygen metabolites, infiltration of inflammatory cells, interstitial edema, cellular dysfunction, and tissue death.

Aim:
The study aimed to investigate the cytoprotective effect of 2-mercaptoethanesulfonate (MESNA) against tissue damage in rats exposed to carotid ischemia-reperfusion.

Materials and Methods:
Twenty-four male Wistar albino rats were divided into four groups (n = 6): sham, carotid I/R, I/R + MESNA (75 mg/kg), and I/R + MESNA (150 mg/kg) groups. To induce ischemia in rats, the carotid arteries were ligated with silk sutures for 10 min; the silk suture was then opened, and 1 h reperfusion was done. MESNA (75 and 150 mg/kg) was administered intraperitoneally 30 min before ischemia-reperfusion. Tissue samples from the animals were taken for histological examination, while the serum levels of some biochemical parameters were utilized to evaluate the systemic alterations. ANOVA and Tukey’s post
hoc tests were applied with a significance level of 5%.

Results:
The ischemia-reperfusion-induced tissue damage as evidenced by increase in serum levels of alanine transaminase, aspartate aminotransferase, alkaline phosphatase, malondialdehyde, lactate dehydrogenase, and matrix metalloproteinases (MMP-1, -2, -8) was significantly (P < 0.05–0.0001) reversed after treatment with MESNA in a dose-dependent manner. Treatment with MESNA (75 and 150 mg/kg), significantly (P < 0.05–0.0001) decreased the I/R-induced increase in serum tumor necrosis factor-alpha (TNF-α) and Interleukin-1-beta (IL-1 β).

Conclusion:
The results of this study suggest that MESNA has a protective effect on tissues by suppressing cellular responses to oxidants and inflammatory mediators associated with carotid ischemia-reperfusion.
Erbium, Chromium:Yttrium-Scandium-Gallium-Garnet (Er, Cr:YSGG) Laser Versus Diode Laser in the Treatment of Pericoronitis
Authors: Eroglu CN , Tunc SK , Yuksek MN , Elasan S 
Published: August 2023

ABSTRACT

Background:
There are limited number of studies about the lasers used for the treatment of pericoronitis infection.

Aim:
To compare the Er, Cr:YSGG laser and diode laser applications clinically in the treatment of pericoronitis infection.

Patients and Methods:
Sixty patients with pericoronitis infection were divided into three groups using block randomization: Er, Cr:YSGG + antibiotic group, n = 20 (mean age: 24.20 ± 6.13; 14 females, 6 males); diode group + antibiotic, n = 20 (mean age: 23.45 ± 2.96; 14 females, 6 males); and antibiotic, n = 20 (mean age: 22.45 ± 3.02; 11 females, 9 males). In addition, laser application was performed for patients in the Er, Cr:YSGG and diode laser groups on the 1st and 2nd days until the extraction day. Tooth extractions were performed on the 3rd day for all patients. Patients’ pain (with visual analog scale [VAS]), lymphadenopathy, and local edema were clinically evaluated in the first 3 days and on the 7th day of treatment.

Results:
Pain score on the 2nd day of treatment was determined to be significantly lower in the Er, Cr:YSGG + antibiotic laser group as compared with the other two groups (P = 0.019). Although regression of lymphadenopathy on the 3rd day was highest (P = 0.025) in the Er, Cr:YSGG group, there was no significant difference between the groups regarding local edema.

Conclusion:
Er, Cr:YSGG laser improved the healing process in the treatment of pericoronitis and made an important contribution to the treatment.
Is the Mental Healthcare Act 2017 fully implementable in India, or does it require amendments?
Authors: Pattnaik Jigyansa Ipsita , Panda Udit Kumar , Ravan Jayaprakash Russell , Gowda Mahesh Ramanna , Malhotra Savita 
Published: August 2023

BACKGROUND:
The Mental Healthcare Act, 2017 (MHCA) was enacted in India to protect the rights of individuals with mental illnesses and improve their access to mental healthcare services. However, despite its progressive nature, the implementation of the MHCA has faced numerous challenges. This manuscript aims to discuss the difficulties encountered in implementing the MHCA in its current form and propose potential amendments to enhance its acceptability and effectiveness.

CHALLENGES:
The authors have tried to evaluate MHCA from an Indian perspective by examining its impact on mental healthcare in the country. It raises pertinent questions regarding the effectiveness of the MHCA, the invocation of key provisions such as Advance Directives and Nominated Representatives, the facilitation of care delivery, adequacy of national resources and infrastructure, public awareness of provisions, and police handling of individuals with mental illness. In addition, the manuscript highlights multifaceted challenges in implementing the MHCA, including the failure to acknowledge the role of family members in providing care, lack of clear procedures and guidelines for treatment implementation, insufficient funding, limited resources and mental health professionals in rural areas, persistent stigma attached to mental illness, inadequate community-based care services, and a limited focus on prevention and early intervention.

RECOMMENDATIONS AND CONCLUSION:
Based on the identified challenges, the authors propose several amendments to the MHCA. These recommendations include provisions for capacity building and manpower training, phased implementation according to economic and infrastructure readiness, involvement of existing institutional bodies in scrutiny, operational definition of capacity to consent, encouragement of community participation, establishment of continued treatment and care in the community for chronic mentally ill patients, clarification of provisions for different mental illnesses, protection for well-meaning clinical decisions, and addressing stigma through strengthened anti-discriminatory measures and public awareness.