bluuebunny/crossref_metadata_2025_split huggingface dataset:
Occult pneumothorax in patients with blunted polytrauma: an experience of Tanta University Hospitals
Authors: Abdelwahab Amr , Salem Heba 
Published: July 2023

Abstract

Aims
The objective of this study was to retrospectively evaluate the incidence, management, and outcome of occult pneumothorax (OPTX) in patients with blunt chest trauma (BCT).

Settings and design
A retrospective observational study was performed.

Patients and methods
Over 9 years, cases with BCT were identified retrospectively from the database between 2012 and 2021. Data were evaluated and compared based on the first management (conservative vs. intercostal tube).

Results
Of the 2113 cases, 51 (2.4%) admitted with BCT during the study period were found to have OPTX. The mean age of patients was 37 ± 6.58 years, and there was a male predominance (78.43%). Intercostal tube intervention was done in 29 (53.8%) cases, and conservative management was done in 22 (43.13%) cases. Cases that needed tube thoracostomy had significantly higher rates of lung and chest contusions and high Abbreviated Injury Scale compared with those who were treated conservatively. However, pneumonia, rib fracture, hospital length of stay, and ventilatory days were insignificantly different between both groups. Overall mortality was 9.8%.

Conclusions
In cases with BCT that did not require major interventions or needed to be mechanically ventilated, their OPTX can be safely managed conservatively.
Role of GeneXpert in extrapulmonary tuberculosis
Authors: Azzouz Ahmed M , El-Sokkary Raafat T I , Wafi Lamiaa S , Khalaf Mohammad G A 
Published: July 2023

Abstract

Background
Tuberculosis (TB) commonly affects the lung (pulmonary TB). Extrapulmonary TB (EPTB) can involve many systems. Diagnosis is often difficult. EPTB may be misdiagnosed with many other inflammatory, granulomatous, and neoplastic disorders. GeneXpert mycobacterium tuberculosis /rifampicin is a valuable test in diagnosis of pulmonary TB. There is limited research about its diagnostic role in EPTB.

Patients and methods
The aim of this study was to assess the diagnostic value of GeneXpert in EPTB. Samples from EPTB cases were sent for standard mycobacterial culture and GeneXpert assay. The sensitivity and specificity of GeneXpert were calculated.

Results
A total of 100 patients were included. Overall, 61 cases were definitely diagnosed as EPTB, whereas 39 cases were negative according to culture. GeneXpert was positive in 40 cases, which represent 65.6% of EPTB cases, and negative in 21 (34.4%) cases. Sensitivity and specificity of GeneXpert was 65.6 and 97.4%, respectively. The positive predictive value and negative predictive value were 97.4 and 64.4%, respectively.

Conclusion
GeneXpert is a rapid, valuable tool in diagnosis of patients with EPTB. It is a highly specific test with fair sensitivity. A multicenter study with larger sample size is needed to evaluate the diagnostic role of GeneXpert in different sites of EPTB.
Polysomnography in women: is there any difference between childbearing period and menopause?
Authors: El Helbawy Rana H , Abo Shady Heba M , El-Koa Amal A 
Published: July 2023

Abstract

Background
Women may have a wide range of symptoms in the menopausal period, which includes vasomotor, mood changes, and disturbances of sleep. Disturbance of sleep leads to adverse health problems with poor quality of life. This study researched the comparison of polysomnographic parameters between menopausal and childbearing women.

Patients and methods
This study was carried out on 47 women (divided into two groups of premenopausal and postmenopausal), who attended for polysomnography in the Unit of Sleep in the Department of Chest Diseases in Menoufia University Hospital from the period of September 2021 to September 2022. After taking informed written consent, all participants were subjected to history taking, full examination, Epworth sleepiness scale, STOP-Bang questionnaire, and polysomnography.

Results
This study was carried out on 47 women who were divided into two groups: group I (29 participants) in menopause with an age of 58.9 ± 6.3 (mean±SD) and group II (18 participants) in the childbearing period with an age of 37.28 ± 8.064 (mean±SD). Polysomnographic parameters showed statistically significant differences between both groups regarding sleep latency (min) (P=0.026), sleep efficiency% (P=0.019), apnea–hypopnea index (P<0.001), O2 desaturation index, and lowest O2 saturation during sleep (P<0.001 and 0.01, respectively).

Conclusion
Women in menopausal women experience more sleep disturbance, insomnia, and sleep breathing disorders than they did during the childbearing years. Women in this age group, therefore, require a more thorough assessment of sleep difficulties and other relevant variables.
Role of interleukin-6 in coronavirus disease 2019 pneumonia: sensitive marker of inflammation, a predictor of ventilatory support and early marker of post-coronavirus disease lung fibrosis. A single center experience
Authors: Patil Shital , Gondhali Gajanan , Acharya Abhijit 
Published: July 2023

Abstract

Background
Robust data on interleukin-6 (IL-6) is available in bacterial infection, and now it can be utilized in the currently ongoing coronavirus disease 2019 (COVID-19) pneumonia pandemic to guide treatment strategy as a marker of inflammation.

Patients and methods
Prospective, observational, and 12 weeks follow-up study, included 1000 COVID-19 cases confirmed with reverse transcription PCR. All cases were assessed with lung involvement documented and categorized on high-resolution computed tomography thorax, oxygen saturation, IL-6 at the entry point, and follow-up. Age, sex, comorbidity, and bilevel positive airway pressure/noninvasive ventilation (BIPAP/NIV) use and outcome as with or without lung fibrosis as per computed tomography severity. Statistical analysis is done by χ
2 test.

Results
In the study of 1000 COVID-19 pneumonia cases, age (<50 and >50 years) and sex has a significant associations with IL-6. High-resolution computed tomography severity score at entry point has significant correlation with IL-6 level (P<0.00001). IL-6 level has a significant association with duration of illness (P<0.00001) comorbidities has a significant association with IL-6 level (P<0.00001). IL-6 level has a significant association with oxygen saturation (P<0.00001). BIPAP/NIV requirement has a significant association with IL-6 level (P<0.00001). Timing of BIPAP/NIV requirement during the course of hospitalization has significant association with IL-6 level (P<0.00001). Follow-up IL-6 titer during hospitalization as compared with entry point abnormal IL-6 has a significant association in post-COVID lung fibrosis (P<0.00001). Follow-up IL-6 titer during hospitalization as compared with entry point normal IL-6 has a significant association in post-COVID lung fibrosis (P<0.00001). Follow-up IL-6 titer during hospitalization as compared with entry point abnormal IL-6 has a significant association in predicting cytokine storm irrespective normal or abnormal of IL-6 at entry point (P<0.0001).

Conclusion
IL-6 has documented a very crucial role in COVID-19 pneumonia in predicting the severity of illness, progression of illness, and ‘cytokine storm.’ Sequential IL-6 titers will help assess response to treatment during hospitalization and analyze post-COVID lung fibrosis.
Bronchoalveolar lavage in lung cancer: does it increase the positive yield of bronchoscopy?
Authors: Salama Khadiga S M , Hafez Manal R , Farag Abeer S , Salim Doaa L A 
Published: July 2023

Abstract

Background
Cells obtained from bronchoalveolar space can give a definite diagnosis in malignancies. The present study aimed to assess the diagnostic yield of bronchoalveolar lavage (BAL) in lung cancer and to assess the relationship of its yield with radiology, endoscopy, and pathological subtypes.

Patients and methods
A retrospective study with re-revision of saved bronchoscopic video, computed tomography (CT) films, and pathology slides was conducted on 101 patients with definite bronchogenic carcinoma diagnosed over 4 years.

Results
BAL positive yield was found in 42.4% of cases, and its yield coincided with other bronchoscopic sampling methods in 43.6% of cases. Regarding CT findings, the BAL positive yield was significantly higher in peripheral lesions (79.1%), mass size more than or equal to 3 cm (62.8%), CT bronchus sign (46.5%), hilar and/or mediastinal adenopathy (86.0%), and consolidation (51.2%). The most common bronchoscopic abnormality in patients with BAL positive yield was submucosal lesions (83.3%). The adenocarcinoma (48.8%) and bronchoalveolar carcinoma (11.6%) were the histopathological types having significant BAL positive yield. The most significant predictive factors for BAL positive yield were mediastinal adenopathy, endobronchial lesions, nonvisible lesions, adenocarcinoma type, submucosal lesions, CT bronchus sign, mass size more than or equal to 3 cm, peripheral lesions, and concomitant use of bronchial brushing. BAL had 40.3% sensitivity, 51.7% specificity, 67.4% positive predictive value, 25.9% negative predictive value, and 43.6% diagnostic accuracy in bronchogenic carcinoma.

Conclusion
BAL increases the positive yield of bronchoscopy by 13.9% with fair diagnostic performance, especially in peripherally locating nonvisible lesions. Although tissue biopsy remains the gold standard sampling, clinicians might rely on BAL cytology for diagnosis of lung cancer in some patients.
Proportion and prognosis of ICU-admitted coronavirus disease 2019-infected patients in relation to all hospitalized cases in Abbasia Chest Hospital, Cairo
Authors: Mahmoud Hend Hashem , Tageldin Mohamed A , Yousef Yehia R 
Published: July 2023

Abstract

Background
Because of the outbreak of coronavirus disease 2019 (COVID-19), there has been an increase in the demand for intensive care services all over the world. Severe cases fulfill one of the following criteria: respiratory rate more than 30/min, oxygen saturation less than or equal to 93%, and PaO2/FiO2 less than or equal to 300 mmHg. ICU admission is required for seriously ill patients who require high-flow nasal cannula, intubation, or more oxygen to treat hypoxemia or multiple organ dysfunctions. However, it is unclear whether patients with COVID-19 who are admitted to the ICU will survive.

Aim
To estimate the proportion and prognosis of ICU-admitted COVID cases in relation to whole COVID cases admitted at Abbassia Chest Hospital and estimation of risk factors responsible for mortality.

Patients and methods
This retrospective observational study was conducted on all cases of COVID-19-infected patients admitted at respiratory ICU of Abbassia Chest Hospital in relation to all hospitalized cases during the period between January 2021 and June 2021. All of the cases were subjected to full history taking, laboratory investigations, and radiological assessment with chest radiograph and computed tomography.
The reported outcomes included weaning from mechanical ventilation, discharge, mortality, and cause of death.

Results
The study included 76 patients with COVID-19. Overall, 43 (56.6%) were males and 33 (43.4%) were females, with a mean age of 57.17 ± 12.54 years. The incidence of mortality was 32.9%. The acute respiratory distress syndrome (ARDS) was the most common cause for ICU admission and encountered in 57.4% of the cases. All of the dead cases had severe ARDS. The use of invasive mechanical ventilation was reported in 76.5% of the included died cases, and this was statistically significantly higher as compared with the survived group. On the contrary, the length of ICU stay was statistically significantly higher in the survived group.

Conclusion
COVID-19 infection is associated with a high percentage of ICU admission with a high mortality rate. Many factors are associated with the high risk of mortality among the ICU admitted COVID-19-infected patients including severe ARDS, deterioration of the systemic organ functions, and the utilization of invasive mechanical ventilation.
Changes in eotaxin-2 and periostin levels in patients with bronchial asthma according to their smoking status: a cross-sectional study
Authors: Abdelghany Mohammed F , El-Karn Atef F , Sherif Mahmoud F , Seddik Mohamed I , Eid Safaa A , Youssif Sahar F 
Published: July 2023

Abstract

Background
Smoking influences the nature of airway inflammation in patients with bronchial asthma though synthesis of certain cytokines. Patterns of bronchial asthma are differentiated clinically, functionally, and regarding inflammatory biomarkers.

Aim
The research aimed to study the clinical, functional, sputum cytological differences, and serum eotaxin-2 and periostin levels in asthmatic patients regarding smoking status.

Patients and methods
The research was a cross-sectional study. The collection of cases began in August 2018 and ended in January 2020 at the Chest Department, Assiut University Hospital. We studied 117 asthmatic patients who were classified regarding their smoking status (45 nonsmokers, 42 smokers, and 30 former smokers) for serum eotaxin-2 and periostin by enzyme-linked immunosorbent assay. The effects of smoking were analyzed on inflammatory cells including eosinophilic and neutrophilic percentages in sputum and serum eotaxin-2 and periostin levels.

Results
Smokers with asthma had worse clinical and functional outcomes. Asthmatic smokers had mainly neutrophilic phenotype. Serum eotaxin-2 level was higher in smokers compared with nonsmokers and former smokers. However, serum periostin level was higher in nonsmokers compared with smokers and former smokers. Serum eotaxin-2 had a positive correlation with smoking index and eosinophilic and neutrophilic count in sputum, whereas serum periostin was correlated negatively with smoking index and positively with eosinophilic count.

Conclusion
Asthmatic smokers had worse clinical and functional outcomes with increased neutrophils in the sputum. The inflammatory biomarkers seen in smokers with asthma showed low serum periostin and increased serum eotaxin-2 levels.
Assessment on Quality of Healthcare Services during Childbirth: A Community-based Mixed-method Study in the Women of Puducherry
Authors: Chellamuthu Lalithambigai , Kanagat Sadhvika , Dakshinamurthy Senkadhirdasan , Boratne Abhijit Vinodrao 
Published: July 2023

Background:
A women’s right to a positive childbirth experience should be the heart of any care provided. To assess the quality of childbirth services and mistreatment by healthcare providers among reproductive age group women and to explore factors influencing the same between women and stakeholders.

Material and Methods:
A community-based, mixed-method study was conducted from April to September 2021 in field practice areas of a medical college in Puducherry district. The sample size for the quantitative study was 348 and the women were chosen using a multi-stage sampling technique. Women were interviewed with a semi-structured questionnaire. In-depth and key informant interviews between women and stakeholders were done for the qualitative data collection.

Results:
Three-fourths (77.0%) of women preferred government tertiary healthcare facilities for obstetric care. Although 69.0% and 75.6% of the participants did not experience any verbal and physical abuse, respectively, the qualitative study results were quite the opposite. While 92.8% of the women complained that no birth companion was allowed during their delivery. Moreover, 79.9% of the women did not have the freedom to choose their comfortable birthing position. The levels of mistreatment in the rural areas were slightly higher than that of the urban areas.

Conclusion:
Quality care is a fundamental approach to maternity care. A fair bit of women experiences mistreatment during childbirth in healthcare setups. However, the chief concern here is the perception of such abuse by the mothers as normal due to their lack of knowledge regarding women’s rights.
To Try or Not to Try: A Questionnaire Study among Women with Previous Lower Segment Cesarean Section
Authors: Kansara Megha , Yadav Garima , Singh Pratibha , Gothwal Meenakshi , Kathuria Priyanka 
Published: July 2023

Background:
The recent increase in the cesarean section (CS) rate worldwide has led to global concerns and vaginal birth after CS (VBAC) as an effective way to reduce the CS rate. In this study, our main aim was to know about various factors that help women make their preferred mode of delivery following a previous CS.

Material and Method:
This was a questionnaire-based study conducted in the Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), Jodhpur, among 200 women with previous one lower segment CS (LSCS).

Results:
Elective repeat cesarean delivery (ERCD) was found to be more among uneducated women and those who had complications in their previous babies. The most common reason for opting for ERCD was fear of labor pains. Women who were counseled by senior doctors were more likely to opt for a trial of labor after cesarean section (TOLAC).

Conclusion:
Improving the education levels of mothers, counseling about advantages associated with vaginal birth, counseling by senior obstetrician, and information regarding labor analgesia can decrease CS rates.
Prevalence of Stress and Insomnia among Health Care Workers in India during COVID-19 Pandemic: A Systematic Review and Meta-analysis
Authors: Khobragade Ashish W. , Agrawal Nitin 
Published: July 2023

Background:Health care workers (HCWs) are prone to stress and insomnia because of pandemic situations. Assessment of the actual burden of this stress and insomnia is essential to form preventive strategies. The study’s objective was to find out the pooled prevalence of stress and insomnia among HCWs in India during the coronavirus disease (COVID-19) pandemic.Material and Methods:We conducted a systematic review and meta-analysis to determine the prevalence of stress and insomnia among HCWs during the COVID-19 pandemic in India. Cross-sectional studies conducted in India regarding stress and insomnia among HCWs were searched from PubMed, Scopus, Embase, and Google Scholar. These studies were published after the declaration of the COVID-19 pandemic till August 31, 2021. Articles were searched independently by both authors. Data were extracted in an Excel sheet and analyzed using the ‘Meta’ package of the ‘R’ software version 4.1.0.Result:A total of 23 and 16 studies were included in the final pooled analysis of stress and insomnia, respectively, following preferred reporting items for systematic review and meta-analysis guidelines. A random-effects model was used to determine the pooled prevalence of stress and insomnia. This study is registered in Prospero. The registration number is CRD42021253917. The total numbers of HCWs from India included were 8125 and 4974, respectively, for finding out the pooled prevalence of stress and insomnia. The pooled prevalence of stress and insomnia among HCWs is 43% [95% confidence interval (CI) 30–56%] and 35% (95% CI 28–44%), respectively. Two out of five and one in three Indian HCWs have stress and insomnia, respectively, during the COVID-19 pandemic.Conclusion:Human resource development should be prioritized to decrease the workload among HCWs. The findings from this study will be useful in preparing policy guidelines on mental health screening of HCWs during the pandemic.
A Global Comprehensive Study of the Distribution of Type I-E and Type I-E* CRISPR-Cas Systems in Klebsiella pneumoniae
Authors: Kannadasan Anand Babu , Sumantran Venil Naranan , Vaidyanathan Rama 
Published: July 2023

Background:
The CRISPR-Cas (clustered regularly interspaced short palindromic repeats–CRISPR-associated proteins) systems are the short DNA sequences and RNA-dependent nuclease involved in the adaptive immunity in bacteria and archaea. The type of CRISPR-Cas system influences antibiotic susceptibility in Klebsiella pneumoniae. Here, our objective was to study the diversity of CRISPR-Cas system in the genome of K. pneumoniae from the available whole genome sequencing (WGS) data.

Material and Methods:
We identified the CRISPR-Cas systems of K. pneumoniae using the CRISPR-CasFinder database. The complete genome sequence and its submission details were obtained from the National Center for Biotechnology Information (NCBI) database.

Results:
A total of 1607 K. pneumoniae whole genome sequences were analyzed. The major contributors of WGS data of K. pneumoniae were China (26.6%), United States (21.5%), Australia (10%), South Korea (8%), India (5.5%), and United Kingdom (4.9%). Out of 1607 genomes analyzed, almost one-fourth were CRISPR-Cas positive (403/1607) and three-fourth were CRISPR-Cas negative (1204/1607). Among CRISPR-Cas positive strains, 220 belonged to type I-E* and 183 were type I-E. Furthermore, type I-E* CRISPR-Cas systems were significantly higher in Asia (P < 0.001), whereas type I-E were significantly higher in Europe (P < 0.01). Among countries, typically, type I-E* strains were found to be higher in China (P < 0.01) and India (P < 0.01), whereas type I-E strains were higher in Germany (P < 0.01).

Conclusion:
Hence, it is important to know the type of CRISPR-Cas systems in K. pneumoniae strains across the countries and it can help to understand the diversity of CRISPR-Cas systems worldwide.
Sleep Quality of Undergraduate Medical Students during and Post-Lockdown: A Cross-Sectional Research
Authors: Sebastian Loana M. , Tojo Joyal , Fathima Farah N. 
Published: July 2023

Background:
The COVID-19 and associated lockdowns have significantly impacted the lives of undergraduate medical students, including their sleep quality. This study attempts to investigate how sleep patterns, sleep quality, and associated factors altered during and post-lockdown.

Material and Methods:
In this cross-sectional study, 171 medical students from colleges registered under the National Medical Council participated. The study used a validated PSQI questionnaire. The data collected through Google forms were analyzed using SPSS v2021.

Result:
Among 171 study participants, 9.4% had bad sleep quality during lockdown which reduced to 4.7% post-lockdown significantly. Sleep latency and sleep duration were also significantly affected by the lockdown. There was a weak correlation between PSQI score during and post-lockdown, suggesting that individuals with poor sleep quality during lockdown also had poor sleep post-lockdown. According to the study, poor sleep quality decreased after lockdown as opposed to lockdown, with improvements in sleep latency and decreased use of sleep duration.

Conclusion:
However, there was a weak correlation between PSQI score during and post-lockdown. Increased screen time during lockdown negatively affected sleep quality, emphasizing the importance of practicing sleep hygiene and promoting outdoor activities to reduce stress levels and improve mental health.