bluuebunny/crossref_metadata_2025_split huggingface dataset:
Total Anomalous Pulmonary Venous Connection with Persistent Left Superior Vena Cava: A Retrospective Surgical Series
Authors: Mishra Amit , Parmar Tarun , Patel Herin , Parmar Divyakant , Jain Imelda , Patel Jigar , Pandya Himani , Sharma Rajesh 
Published: August 2023

Introduction:
Total anomalous pulmonary venous connection (TAPVC) is a common cyanotic congenital heart disease seen in developing countries at tertiary referral centers. Association with persistent left superior vena cava (LSVC) without innominate vein (H-connection) is an extremely rare condition which makes the surgical correction extremely challenging.

Materials and Methods:
This was a retrospective case record review of 18 patients with TAPVC in the presence of LSVC without innominate vein (without H-connection) at our institution from January 2007 to February 2021. We detail our experience of our modified surgical technique for this complex anatomy using various modifications for each type of TAPVC with LSVC in the absence of innominate vein.

Results:
Out of 18 patients of TAPVC with LSVC, 17 patients survived and are being followed up regularly. There was one mortality (5.5%) in a 5-month-old infant with double-outlet right ventricle with ventricular septal defect with severe pulmonary arterial hypertension with infracardiac TAPVC who died in intensive care unit on the 5th postoperative day.

Conclusion:
In our experience, the modified surgical technique for treating this complex variant of TAPVC is especially useful for favorable long-term outcomes with minimal incidence of recurrent pulmonary venous obstruction.
Parents’ perception about children screen time and myopia during covid-19 pandemic
Authors: Shetty Aksha , Naik Nehal , Usgaonkar Ugam P. S. 
Published: August 2023

Purpose:To understand parents’ perception of children’s screen time and myopia during the COVID-19 pandemic.Methods:In this e-survey, 413 parents were included. It was designed on the “Google Forms website and distributed through the social media platform.” The information was collected regarding parent perception of children’s screen use and time spent on digital devices during and after the post-COVID-19 pandemic and knowledge about myopia. The statistical analysis was carried out using SPSS.Results:In this study, 56 children were myopic according to parental responses. The majority of the parents reported their child is spending more time watching television (73%) and using smartphones (79%) which included playing video/online games (75%) and participating in e-learning (75%). 60% of parents agree that prolonged screen time is harmful to children’s eye health. It was seen that children were spending >4 hrs/day using electronic devices which is 48% since the pandemic began, up from 20% before the pandemic with aPvalue of <0.05. Overall, 75% of parents believed myopia to be a very/somewhat serious problem for their children. 61% of parents correctly answered that glasses are not the only option for myopia.Conclusion:Parents, as well as children, had increased screen time as compared to the pre-pandemic situation in activities like watching TV, and using a smartphone which included playing online games and e-learning. Children’s screen time had doubled compared to pre-pandemic in almost all age groups. Parents should further be educated on how to control their children’s screen time. Parents had adequate knowledge about myopia and risk factors but further awareness about it is required.
Efficacy of topical immunotherapy in the management of Ocular Surface Squamous Neoplasia (OSSN)– A retrospective analysis
Authors: Thulaseedharan Sinumol S. , Raghavan Ajithkumar V , Sankar Ashwati , Sujatha N , Vaikkakara Sudha , Krishna T Devu 
Published: August 2023

Purpose:To evaluate the efficacy of topical immunotherapy with Interferon α 2b [INF- α 2b] drops with a concentration of 3 million international units per millilitre (3 MIU/ml), in the treatment of noninvasive Ocular Surface Squamous Neoplasia (OSSN).Methods:A retrospective case record-based study of patients with noninvasive OSSN, who were treated with INF- α 2b drops (3 MIU/ml) during the period from January 2016 to January 2020 at a tertiary care centre in South India. The demographic details, clinical findings, slit lamp photographs, investigations, histopathological records, clinical course, mean duration of clinical and cytological resolution, any evidence of intolerance to treatment, failure to treatment, and recurrences were analysed.Results:Fourteen eyes of 12 patients were studied. The majority of patients were male (83%) and aged more than 50 years (83%). 64.28% of cases became disease free clinically and histopathologically in 3 months. 21.4% of cases showed partial resolution.Conclusion:Topical immunotherapy is an effective mode of treatment for noninvasive OSSN. The 3 MIU/mL dose of topical IFN-α2b drops helped in faster resolution. No recurrences were reported. No severe surface toxicity or intolerance was observed.
Blind spot in ultrasound central corneal thickness measurement – Central corneal thickness of apex versus central corneal thickness of vertex
Authors: Ramesh Prasanna Venkatesh , Parthasarathi Sathyan , Ashok Abhinay , John Rajesh Kumar 
Published: August 2023

Aims:
This study aimed to compare central corneal thickness (CCT) using ultrasound pachymetry (USP) (CCT apex) and specular microscopy (CCT vertex) and also to find out the intra-reading variability from the two instruments.

Settings and Design:
A prospective, observational study was conducted in a tertiary eye care center in southern India.

Materials and Methods:
This study was conducted on 12 patients (24 eyes, 96 data set eyes, 768 data points in total) aged 20–50, in non-pathological corneas. Eight CCT measurements by specular microscopy and eight measurements by USP were taken by two different experienced observers on day 1, followed by repeating the same on day 2.

Statistical Analysis:
The readings were averaged and compared by paired t-test. SPSS software was used for statistical analysis. Variability between the eight readings produced by the same instrument was calculated and coefficient of variation was plotted. Inter-examiner variability and intra-examiner variability of the two modalities were studied, and it was considered statistically significant if P < 0.05.

Results:
The mean CCT by USP was 522.71 µm and the mean CCT by specular microscopy was 519.43 µm. The coefficient of variation of the eight readings varied significantly between the machines. On an average, the coefficient of variation was 0.4% compared to 0.8% in specular microscopy and USP, respectively.

Conclusion:
The intra-reading variability of ultrasound CCT is twice as that compared to specular microscopy. The clinical relevance of this spread is relevant and important in modern-day practice. Hence, it is better advisable that CCT readings from both the modalities, not be used interchangeably.
Evaluation of tacrolimus and cyclosporine in the treatment of vernal keratoconjunctivitis in children
Authors: Suresha A. R , Shashidhar Gaargi , Prabhudeva H 
Published: August 2023

Aims:
To compare the efficacy and safety of 0.03% tacrolimus eye ointment with 2% cyclosporine eye drops in the treatment of vernal keratoconjunctivitis.

Settings and Design:
Comparative, Hospital-based, Prospective, Randomized, Clinical study.

Methods and Material:
About 56 children diagnosed with Vernal keratoconjunctivitis (VKC) were enrolled in the study. All the subjects underwent a comprehensive ophthalmic evaluation. Total subjective symptom scoring (TSSS) and Total objective sign scoring (TOSS) were done for each patient based on their history and clinical examination. They were divided into two groups. One group was treated with 0.03% tacrolimus ointment bd and the other with 2% cyclosporine eye drops tid. Both groups were also put on carboxymethylcellulose eye drops four times a day. Steroids were never used during the study. The patients were followed up at intervals of two weeks, four weeks, and eight weeks. At each follow-up, the TSSS and TOSS were done for each patient. Patients were also questioned about any adverse effects encountered by them during the treatment. A comparison was done between both groups based on the above scoring.

Results:
There was progressive reduction which was statistically significant (P < 0.05) in the TSSS and TOSS in both the groups throughout treatment. Reduction in TSSS The only adverse effect reported by a few patients was a burning sensation that was not severe enough to discontinue treatment.

Conclusions:
Both tacrolimus 0.03% eye ointment and cyclosporine 2% eye drops are effective in the treatment of VKC without any significant severe side effects. Tacrolimus eye ointment was more effective than cyclosporine drops.
Normative Reference Values for Functional, Lateral, and Oblique Direction Reach Tests in Saudi Children Aged Six to 15 Years Old and Psychometric Properties of the Oblique Direction Reach Test
Authors: Tedla JS , Sangadala DR , Gular K , Reddy RS , Alshahrani MS , Ahmad I , Abohashrh M 
Published: August 2023

Aims:
To establish normative values for functional, lateral, and Oblique Direction Reach Tests (ODRT) and to assess the validity and reliability of the ODRT in Saudi children of age 6–15 years.

Methods:
Three hundred Saudi children of age 6–15 years children were recruited by using snowball sampling. Children were measured for distance reached in forward, lateral, and oblique direction on a graph paper, which was mounted on a wall/cardboard.

Results:
The Mean ± SD for forward, lateral and oblique direction reach was 25.63 ± 6.95, 18.91 ± 5.66, 22.08 ± 5.98 cm respectively. The Intraclass Correlation Coefficient values of intra and inter-rater reliability of ODRT shown to be 0.94 and 0.91, respectively. Concurrent validity of ODRT with forward and lateral reach test is 0.87 and 0.84, respectively.

Conclusion:
We established the normal values for functional, lateral, and ODRT in 6–15 years of Saudi children. We found that ODRT is a valid and reliable for measuring limits of stability in oblique direction.
Mismatch Repair Protein Expressions in Cohort of Colorectal Carcinoma Patients in Lagos
Authors: Badmos KB , Adebayo LA , Osinowo AO , Lawal AO , Habeebu MY , Rotimi O , Abdulkareem FB 
Published: August 2023

ABSTRACT

Background:
Colorectal carcinoma (CRC) is a major cause of morbidity and mortality worldwide. Microsatellite instability pathway is important in the pathogenesis of CRC. Immunohistochemistry expression of mismatch repair (MMR) proteins serves as surrogate marker for MMR gene mutation.

Aims:
This study aimed to determine MSI status of a cohort of CRC cases using immunohistochemistry.

Materials and Method:
Surgical pathology blocks of resected colonic carcinoma (CC) between 2011 and 2015 were extracted from our departmental archives and The Specialist Laboratories in Lagos. Immunohistochemical expression profile of 4 MMR proteins was assessed in the representative blocks and this was correlated with the demographic and pathological characteristics.

Results:
There were 19 males and 16 females with CC, mean age of 51.6 years, and 40% of them were below 50 years of age. Twenty (57.1%) out of the 35 CC cases seen were mismatch repair proficient (pMMR) while the remaining 15 (42.9%) were mismatch repair deficient (dMMR). Seven dMMR cases were seen equally on the right and left colonic tumors respectively. Five (71.4%) out of the 7 mucinous tumors in this study were dMMR, right sided with 3 of them in patients who were below 50 years of age.

Conclusion:
The frequency of mismatch repair deficiency in CC among Nigerians is high, and presence of right-sided mucinous colon cancer in patients below 50 years is highly suggestive of dMMR status. Mutation studies of larger patient samples to determine the percentage with germline mutation will further our knowledge, and influence therapeutic options for CC.
Parent Participation in Early Intervention/Early Childhood Hearing Impairment Program
Authors: Sevinç Ş , Şenkal ÖA 
Published: August 2023

Background:
It is a well-known fact that the parents play a key role in the early intervention program for their deaf and hard of hearing children.

Aims:
This study aims to focus on issues related to the need for a collaborative, supportive and parent centred early intervention programs and (re)habilitation process for the children with hearing aids or cochlear implants for sustainable health. This study was a retrospective case control study.

Subject and Methods:
Sixty parents (30 parent educated and 30 non- parent educated) were completed a Profile Questionnaire and a Family Awareness and Knowledge Questionnaire. The first questionnaire was designed to obtain the information related with the demographics of the family and their deaf or hard of hearing children. The latter was used to evaluate the knowledge of parents about their hearing handicapped children. All statistical analyses were performed with IBM SPSS Statistics, Version 22.0 software (Armonk, NY: IBM Corp).

Results:
The parent awareness and knowledge of children with cochlear implants differed from those of control group who do not receive any family counselling, but not in clinically significant ways.

Conclusions:
Some of the variability in cochlear implantation outcomes that have protracted periods of development is related to family environment. Because the family environment can be modified and enhanced by therapy or counselling, these preliminary findings hold promise for future work in helping families for sustainability in health.
Schooling and Nigerian Children with Asthma
Authors: Kuti BP 
Published: August 2023

ABSTRACT
Epidemiologic studies have reported increasing prevalence of childhood asthma in Nigeria and other developing countries where there are parallel increases in school enrolments. Children with asthma face lots of challenges in school which can affect their academic performance and quality of life. This narrative review highlights the challenges and the risks of schooling encountered by Nigerian children with asthma and the prospects of utilizing the School Health Programme (SHP) to overcome these challenges. An electronic search of relevant published articles from 2000 to 2020 was carried out using appropriate search engines for the following words: “schooling”, “childhood asthma”, “school health programme”, “school environment,” “health instructions”, “school health services” and “asthma care in schools”. The challenges and risks the school age asthmatics encounter in school include discrimination and victimization, exposure to triggers on the road and in the school environment, poor and non-existence asthma care services in schools, suboptimal knowledge of teachers and caregivers about childhood asthma hence poor asthma-related instructions and increased school absenteeism. The prospects of SHP as a tool to overcome these challenges are highlighted. These include the roles expected to be played by all stakeholders – the government and education authorities need to revise and more effectively implement the school health policy. The roles of asthma care professionals include the need to “adopt” schools to ensure optimal asthma care for the school population and the all-important enlightenment of teachers, school health workers, parents/caregivers and school children for overall improved asthma care delivery in Nigerian schools.
Comparison of Orthodontic Treatment Need among Professionals and Parents in Dammam, Saudi Arabia
Authors: Al-Khalifa KS , AlDabbus HR , Almadih AI , Alaqeeli HM , Almarshoud AA , Muhana MH , Alzaidani SD , Nassar EA 
Published: August 2023

Aims:
This study aimed to assess parents' awareness and attitude regarding their children's malocclusion compared with professional assessments and to measure the prevalence of malocclusion among children in Dammam, Saudi Arabia.

Methods:
The study population consisted of 377 randomly selected children (aged 8–12 years) from five schools in Dammam, Saudi Arabia. A questionnaire was used to assess parents' awareness using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) and knowledge about preventive orthodontics. A clinical examination was performed by two calibrated examiners to measure the prevalence of malocclusion using both the AC and dental health component (DHC) of IOTN.

Results:
The most common Angle's molar relationship was Class I (78.2%), followed by Class II (17.5%) and Class III (4.2%). The DHC (score 3–5), which indicated the need for orthodontic treatment, was 55.4%. There was a significant difference (P < 0.05) between AC from examiners and parents, whereby the parents tended to underestimate their children's malocclusion by a factor of 1.45. Surprisingly, many parents (67.4%) lacked knowledge about preventive orthodontics.

Conclusions:
Class I malocclusion was most prevalent among children in the area of Dammam. A moderate percentage (55.4%) of the study subjects required treatment based on the DHC. Based on the lack of knowledge about preventive orthodontics in the majority of parents in our study, it is recommended that oral health-promoting programs be implemented to improve the awareness of malocclusion in the region.
The Measurement of Different Diaper Parameters for the Evaluation of Postcircumcision Bleeding and Their Significance for the İnfant's Health
Authors: Akman M 
Published: August 2023

Background:
Evaluation of circumcision bleeding cannot depend on the visual change in the diaper. Diapers have different product features and absorbency capacities. The apparent changes in the diapers may vary according to their absorbent capacity and may not be in parallel with the amount of bleeding. Before significant visual difference occurs, the patient's hemodynamics may be impaired.

Aim:
Aim of the study is to evaluate better circumcision bleeding.

Patients and Methods:
Patients were divided into groups according to 12 different brand diapers of the same size, containing super-absorbent material. The study started by 15/01/2022, and finished by end of 01/03/2022. Diapers with concealed brands were soaked with blood with equal hematocrit value in 100 ml with increments of 5 ml. 252 images were obtained by taking 21 images of each diaper with the same method. The diapers were evaluated colorimetrically, and numerical values were obtained showing the color differences in red, green, and blue and saturation and lightness. Working groups were formed according to 12 different brands of diapers of the same size, containing super-absorbent material. Standard statistical tests were performed using obtained values.

Result:
Dry diapers had different weights, volumes, and specific gravities; the diapers with the lowest unit weight were ranked ninth in terms of volume; the diapers with the highest specific gravity were ranked third in terms of thinness. There were significant differences in the blood on the diaper, and significant differences between some groups (p < 0.005); on the other hand, there was not any difference between some other groups (p > 0.05). There was a significant relationship in terms of Analysis of Variance (ANOVA) (P < 0.05 and P < 0.01). Visual graphic examination showed that linear but non-parallel color changes occurred. As the blood load increased, the visual and statistical differences between the diapers became more pronounced, and the curves diverged.

Conclusion:
Visual evaluation of the color change of the diapers may not give accurate results for bleeding follow-up. If necessary to use diapers after circumcision, it is more appropriate to prefer those with low absorbency capacity. Using fabric or cotton products in cases with bleeding risk may be recommended. If bleeding is suspected, hemogram control is the most appropriate option. Diaper manufacturers should warn consumers of the risk. In conclusion, we should be on the safe side for mortality and morbidity.
Are The Perfusion İndex and Pleth Variability Index Title an Early İndicator of Brachial Plexus Block?
Authors: Koca E , Öterkus M 
Published: August 2023

Background:
Studies on the evaluation of the Perfusion Index (PI) and the Pleth Variability Index (PVI) and the success of PI and PVI block in patients undergoing brachial plexus are limited and quite inadequate.

Aim:
In our study, we aimed to compare PI and PVI between the interscalen block and infraclavicular block and evaluate its use as an early marker in block success.

Patients and Methods:
Single-center prospective randomized controlled trials. Preoperative unit, operating room. Patients over 18 years of age who have had upper extremity surgery. Brachial plexus block (interscalene, infraclavicular). Demographic data, Hemodynamic parameters, Perfusion index and Pleth Variability Index. 40 patients, including ASA1-2, 20 patients over the age of 18, who were planned for upper extremity surgery, in the interscalen group, and 20 in the supraclavicular group, were included in the study. Demographic data of the patients were recorded by measuring PI and PVI values at baseline before the block and at the 1st, 5th, 10th, 15th, and 20th minutes after the block, both simultaneously.

Results:
62.5% (n = 25) of the patients included in the study were female. The mean age of the patients was detected as 52.63 ± 16.472, the mean BMI as 26.57 ± 4.423, and the mean entry hemoglobin level as 13.71 ± 1.87 g/dL. The hemodynamic data of the groups were similar across the time periods. The increase in PI increased significantly after 1 minute in both groups. The PVI was similar between the groups at all measurement times.

Conclusion:
In our study, we observed an increase in PI from the 1st minute compared to the non-blocked arm in successful block applications. We consider the early indicator of PI in the evaluation of block success. In our study, we did not observe a significant change in the arm that was blocked and the arm that was not treated with PVI.
A Rare Complication of Pica
Authors: Ekinci F , Yildizdas D , Horoz OO , Kilic S , Gokay N 
Published: August 2023

ABSTRACT
Tracheobronchial foreign body aspiration (FBA), a common pediatric presentation to emergency departments, is still a public healthcare problem affecting children all over the world. There are several types of foreign bodies reported from different parts of the world, including both organic or nonorganic substances. Pica, another interesting clinical entity, is characterized by persistent eating of nonnutritive substances, which is inappropriate for the maturation stage of the individual. A 3-year-old pediatric patient was admitted to our emergency department with a 3-day history of coughing and new onset respiratory distress. A chest X-ray was performed and it showed a suspicious radiopaque foreign body in the localization of left bronchi. Urgent rigid bronchoscopy was performed. The foreign body in the left main bronchi was, surprisingly, a 0.5–1 cm diameter, irregularly shaped stone particle. The laboratory evaluations and patient history revealed the diagnosis of severe iron deficiency anemia and accompanying pica. Stone aspiration, as an FBA, is a rare but potentially life-threatening complication of pica. Iron deficiency anemia accompanied by pica should be diagnosed and treated in the early stage of the disease because of their complications. According to our knowledge and literature search, this is the first case of stone aspiration as a complication of severe iron deficiency anemia and pica.