bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Surveillance Study of the Serotypes of Streptococci in the Throat and Skin Lesions in Acute Rheumatic Fever and Rheumatic Heart Disease Patients and their Families
Authors: Arumugam Praveen , Yadav Amit , Rawat Yogita 
Published: February 2023

Abstract

Objectives:
The objectives of this study were to determine the colonization of the throat and skin among patients of rheumatic heart disease (RHD) or acute rheumatic fever (ARF) and to elucidate the different Lancefield serotypes of streptococci (Group A, Group C, and Group G) among them.

Methods:
The prospective observational surveillance study was conducted from November 2016 to March 2018 among 161 enrolled family members belonging to 30 families with one of their patients being diagnosed with RHD/ARF. The outcome measures were period prevalence of serotypes of streptococci, streptococcal colonization of throat and skin lesions, and association of age and antibody titers with RHD/ARF.

Results:
Out of 30 families enrolled in our study, positive throat (n = 18)/skin (n = 1) cultures were found in 7 families (n = 19). The cultures were positive only for Group A streptococci (GAS), while none of the samples showed positivity for Group C or G serotypes. Overall period prevalence for our study period was 3.2%. Among the 18 members positive for GAS throat culture, 13 (72.2%) belonged to the age group <15 years (P < 0.025). The positive cultures in the throat sample were more in the ARF families than RHD families (P < 0.001). There was no association of culture positivity with antibody titer (P > 0.05).

Conclusion:
In conclusion, we found only GAS colonization in significantly higher proportion among the family members of cases of ARF in comparison to RHD. Rather there was no case of Group C and G streptococci colonization in cases or family members of RHD/ARF.
Melioidosis: Is it Still Underdiagnosed?
Authors: Kamath Vasantha , Priyanka M. , Reddy Deepthi 
Published: February 2023

Abstract

Burkholderia pseudomallei, a Gram-negative bacterium, is the cause of Melioidosis, a disease that is known to cause significant morbidity and mortality in Southeast Asia. It is also classified as a potential biological warfare agent and is considered a category B priority pathogen. Despite being common in these areas, melioidosis is often underdiagnosed due to lack of awareness of its clinical and microbiological characteristics, limited health-care resources, and the varied ways in which it can present. It is important to recognize the clinical features of melioidosis early on and properly manage the disease to reduce its impact.
Role of Polymerase Chain Reaction in Peritoneal Dialysis Patients with Nonbacterial Peritonitis
Authors: Srivastava Atul Kumar , Ghosh Indranil , Dubey Sudhir , Sonawane Shrikant 
Published: February 2023

Introduction:
Culture-positive peritoneal dialysis (PD)-related peritonitis depends on proper sample collection and culture technique. Patients are investigated for fungal and tubercular peritonitis once the initial peritoneal effluent grows no bacteria and the patient is unresponsive to antimicrobials. However, they are diagnosed late in the course of illness and lead to irreversible peritoneal damage preventing reinsertion of PD catheter. The aim of the study was to assess the role of polymerase chain reaction (PCR) in diagnosis of fungal and Mycobacterium tuberculosis (MTB)-related peritonitis in patients on PD who presented with features of peritonitis.

Materials and Methods:
This was a prospective study and included patients who were diagnosed to have PD-related peritonitis as per the International Society of PD guidelines. All patients underwent panfungal and MTB complex (MTC) PCR of PD effluent on day 1 of admission.

Results:
Eighty-five patients with PD-related peritonitis were included in the study. In patients with no bacterial growth on PD fluid, panfungal PCR was positive in 22 (25.8%) patients and 2 (2.4%) patients had positive MTC PCR. Fungal organism could be isolated in 10 (11.7%) patients. Nine percent of patients with fungal peritonitis died.

Conclusion:
The use of PCR in patients with PD-related peritonitis will help in early diagnosis and management of fungal and tubercular peritonitis. It will also help in reducing mortality in these patients.
Cutaneous Manifestations of Systemic Lupus Erythematosus: A Descriptive Study from a Tertiary Care Center in Southern India
Authors: Ashwini N. , Jayashankar C. A. , Pinnelli Venkata Bharat Kumar , Prakash Bhanu , Gundreddy Honika , Shalini A. S. 
Published: February 2023

Abstract

Background:
Systemic lupus erythematosus (SLE) is a complex autoimmune disease that affects multiple systems in the body, including the skin. It is more common in women and usually occurs in the fourth decade of life. The skin is the second most frequently affected organ in SLE, occurring in about 80% of patients.

Aim:
The purpose of this study was to analyze the clinical and epidemiological characteristics of SLE and evaluate the different patterns of cutaneous involvement in SLE patients.

Materials and Methods:
Sixty newly diagnosed SLE patients (17 male, 43 female) aged 9–58 years were included in the study.

Results:
Malar rash was observed in 44 (73.3%) patients, discoid rash in 17 (28.3%) patients, photosensitivity in 38 (63.3%) patients, and oral ulcers in 30 (50%) patients. All these skin lesions were associated with underlying systemic involvement.

Conclusion:
Our study found that active cutaneous manifestations of SLE were strongly correlated with systemic involvement.
Parental Perspectives Regarding Circumcision during the Coronavirus Disease 2019 Pandemic in Indonesia
Authors: Kurniawan Jemmy , Daryanto Besut , Nurhadi Pradana , Kustono Andri 
Published: February 2023

Background:
Coronavirus disease 2019 (COVID-19) pandemic has rapidly spread worldwide and affected the healthcare system, including the deferral of surgical practice. There are various reactions regarding delayed surgeries, but parental viewpoints towards circumcision remain scarce.

Aims and Objectives:
In light of the pandemic, this study aimed to evaluate how parents feel about circumcision and the probable determining variables.

Materials and Methods:
This study is a cross-sectional study based on an online questionnaire available from March to April 2022. The factors affecting the decision were analysed using logistic regression.

Results:
Of 1,218 (26.28%) parents who completed the survey, 879 (18.96%) met the inclusion criteria and were included in this study. Among them, 615 (70.00%) parents agreed to delay circumcision during the COVID-19 pandemic. These respondents were more likely to be non-Muslim (P = 0.01), have no relatives whose work is related to medicine or paramedicine (P = 0.02) and have monthly income equal to or below the regional minimum wage (P = 0.03). After adjusting the potential confounder, non-Muslim religion (odds ratios, 2.87; 95% confidence interval, 1.27–6.49; P = 0.012) was found to be the only independent predictor for agreeing to the deferral of circumcision amid the pandemic.

Conclusion:
Most parents agreed to postpone circumcision due to the fear of COVID-19 exposure. In order to help them feel less apprehensive about this matter, it is important to educate them about the medical benefits of circumcision and the safety of this procedure.
Lung Hydatid and Broncho-Cavitary Communications
Authors: Sharma Nitin , Sharma Shipra , Memon M. Amin , Sharma Mini 
Published: February 2023

Aims:
The aim was to analyse the challenges and outcomes in operated patients of hydatid lung with broncho-cavitary communications.

Materials and Methods:
The retrospective data between June 2017 and May 2022 were obtained. The number of broncho-cavitary communications was recorded and they were suture repaired using polypropylene. The duration required for repair and the average fall in the SpO2 were recorded. Those with incomplete data or follow-up were excluded. The outcome parameters considered were number of broncho-cavitary communications, duration of stay, duration of intercostal tube, duration of air leak and requirement of ventilator support.

Results:
A total of 33 patients out of 36 formed the study group. The mean age was 6 years (range 2–18 years). There were 23 right-sided, eight left-sided and two bilateral cysts. Broncho-cavitary communications were seen in 33 patients. The average number of communications was 3 (range: 2–8). The average duration required to suture close the communications was 30 s (range 20–180 s). The average fall in the SpO2 was 40% (range 20%–74%). The main challenge was rapid identification of communications and prompt repair. The mean duration of surgery was 2.15 h (range 1.45–3.15 h). Ventilator support in the post-operative period was required in four patients. The average duration of intercostal tube drainage required was 7 days (range: 6–14 days). The average duration of hospital stay was 14 days (range 12–34 days). All the communications were repaired using Prolene 3-0 sutures. None of the patients was operated with a double-lumen endobronchial tube.

Conclusion:
Broncho-cavitary communication in hydatid cyst is associated with an operative challenge due to sudden air leak. These patients require judicious management.
A Prospective Epidemiological Survey of Paediatric Trauma in Africa
Authors: Ali Abdelbasit Elsayed , Ademuyiwa Adesoji O , Lakhoo Kokila , Kefas John , Houmenou Esperance , Abdulsalam Moruf , Leopold Azakpa , Bankole Rouma , Gbenou Seraphin , Covi Pautin 
Published: February 2023

Background:
Trauma is a leading cause of morbidity and mortality in children worldwide. There is a need for development and provision of efficient paediatric trauma services based on adequate information and funding which are lacking in low- and middle-income countries.

Aims:
This study was carried out to assess the scale of the problem, identify the most common causes of trauma in Pan African Paediatric Surgical Association (PAPSA) zone and to define the limiting factors for provision of the necessary services required to reduce the potential mortality and disability.

Materials and Methods:
Data were collected through an electronic form sent out in PAPSA platform. Members were requested to provide prospective data on all paediatric major trauma admitted to or seen at their health facilities between the beginning of April 2019 and the end of June 2020. Hospital location, child’s age, gender, type of injury, mechanism of injury, severity, initial management, method of transport, time to arrive to hospital, availability of surgical specialities, length of hospital stay and injury outcome were analysed.

Results:
There were 531 entries. The mean age was 3.53 years and median age 1.34 years. Male-to-female ratio was 2:1. The leading causes for injuries were falls 194 (36.53%) and motor vehicle crashes (MVCs) 176 (33.15%) followed by obstetrical 42 (7.9%), thermal 27 (5.1%) and domestic injuries 22 (4.1%). The most common injuries were limb fractures 181 (34.1%) and traumatic brain injury 111 (20.9%). Public and private transport were used in 313 (58.9%), while ambulance service was used in only 54 (10.1%). Distances to a health facility varied between 1 and 157 km. 70.2% of cases did not receive any primary care, while definitive care was received in 95.5% of the cases. Outcome was full recovery in 90.6% of patients, morbidity in 8.1% and a mortality rate of 1.3%.

Conclusions:
Most of the injuries were in the under 5-year age group. The two main causes of trauma in children in this study were the falls from height and MVCs. Long distance travels to reach health-care facilities were noticeable in this study, together with substantial lack of adequate ambulance facilities and shortage in necessary subspecialty services such as neurosurgical, orthopaedics and rehabilitation. Implementing proposed recommendations can reduce the burden.
Outcome of Transanal Endorectal Pull-Through in Patients with Hirschsprung’s Disease
Authors: Sholadoye Tunde Talib , Ogunsua Oluseyi Oyebode , Alfa Yakubu , Mshelbwala Philip Mari , Ameh Emmanuel Adoyi 
Published: February 2023

Background:
Transanal endorectal pull-through (TERPT) has become one of the preferred treatments for Hirschsprung’s disease (HD) in our setting. This report aims to evaluate the current outcome of TERPT in the setting.

Materials and Methods:
A retrospective review of 71 children who had TERPT for histologically-confirmed HD in 11 years (2006–2017) in Nigeria.

Results:
There were 48 boys and 23 girls; aged 3 days–12 years at initial presentation (median = 10 months). Three (4.2%) patients had associated anomalies (duodenal atresia; anorectal malformation and sensorineural deafness with hypopigmented skin patches each). Age at TERPT was 2 months to 15 years (median = 3 years), with surgery waiting time of 1 month-14.9 years (median = 18 months). Sixty-six (93.0%) patients had rectosigmoid, four (5.6%) patients had long segment and one (1.4%) had total colonic disease. Five (7.0%) patients with large megacolon and one (1.4%) with the total colonic disease had assisted abdominal resection of the colon at TERPT. Seventeen (23.9%) patients had post-operative complications, including post-operative enterocolitis 8 (11.3%); anastomotic dehiscence 3 (4.2%); retained aganglionic segment 2 (2.8%); anastomotic stenosis 2 (2.8%), resulting in prolonged hospital stay (P = 0.0001; range = 1–30 days; median = 5 days). The mortality rate was 4.2% (3) from malignant hyperthermia in one patient and in 2 patients, the cause of mortality was unclear. Patients were followed up for 3–6 years (median = 3.5 years). Bowel movement stabilised to 2–4 times daily by 6 weeks after surgery.

Conclusion:
TERPT is a safe treatment for HD in this setting with good short-term outcomes. Longer follow-up is necessary to further evaluate the long-term bowel movement outcomes.
Role of computed tomography angiography in deep inferior epigastric perforator flap breast reconstruction surgery: A retrospective observational study
Authors: Mahajan Abhishek , Jain Kalpesh , Agarwal Ujjwal , Gupta Himanshu , Agarwal Rajat , Jaiswal1 Dushyant , Shankhdhar Vinay , Mantri Mayur , Popat Palak , Mathews Saumya , Yadav Prabha 
Published: February 2023

ABSTRACT

Background:
Deep inferior epigastric perforator (DIEP) flap is a technique used for breast reconstruction where the skin and subcutaneous tissues of the abdominal wall are transferred to the chest wall post-mastectomy. Computed tomography (CT) angiography localizes perforators along the anterior abdominal wall.

Objectives:
We conducted a retrospective study with the primary objective of evaluating the role of CT angiography in identifying the ideal perforator for the DIEP flap reconstruction and concordance between the radiologically identified perforator and the perforator preferred by the surgeons.

Materials and Methods:
Between July 1, 2015 and September 15, 2019, we included 106 patients in this retrospective study conducted in the Departments of Radiodiagnosis, and Plastic and Reconstructive Surgery at the Tata Memorial Hospital in Mumbai, India. These patients had a CT scan of the deep inferior epigastric artery perforator performed prior to reconstructive breast surgery with DIEP flap. Patients who underwent DIEP flap reconstruction surgery without prior imaging, breast reconstruction other than DIEP flap, and those with a history of abdominal surgeries like abdominoplasty or colostomy were excluded. Two radiologists blinded to the surgical details analyzed the pre-operative CT images to identify the ideal DIEP perforator. Radiological findings were compared with the surgical outcomes and complications.

Results:
The mean age of the patients was 36.7 years (interquartile range, 31.6-41.8). The most common type of the deep inferior epigastric artery in our population was type 2 (deep inferior epigastric artery dividing into two intramuscular branches) on either side. Concordance between the perforator identified on imaging and that selected by the surgeons was 80%. The selection of the larger caliber right sided perforator showed decrease in the recipient site complications; P=0.002.

Conclusion:
The strong correlation between the perforator selected by the surgeons and the one seen on imaging highlights the importance of imaging before the surgery in improving surgical planning and clinical outcomes. A dedicated protocol based on CT angiogram for DIEP is imperative in order to locate the best perforator which can be correlated intraoperatively and be considered the ideal perforator.
Clinicopathological analysis of ischemia/reperfusion time-zero injury biopsies and its role in early allograft dysfunction in hepatic transplantation (retrospective cross-sectional study)
Authors: Abd Elmaogod Eman A. , Hegazy Azza , Mahmoud Abla S. , Marwan Ibrahim , Hegazy Osama , El-Abgeegy Mohamed , Elsergany Heba F. , Mahmoud Eman I. El-Desoki , Mohamed Amal A. , Soliman Hossam E.M. , Seleem Mohamed I. , Gerges Shawkat S. , Albotaly Ahmed , Hamdy Ahmed , Abdelaziz Heba , Abdelraouf Amr 
Published: February 2023

Background and objectives
Orthotropic liver transplantation is the only choice for treatment of end-stage liver diseases. B cell lymphoma 2 (BCL2) is a protein that regulates apoptosis. We aim to pinpoint the role of time-zero biopsies in predicting early graft dysfunction following liver transplantation by evaluation of BCL2 expression in hepatocyte.

Patients and methods
Thirty seven liver biopsies were evaluated histopathologically for ischemia–reperfusion injury and immunohistochemically by expression of BCL2.

Results
Out of 37 cases studied, 33 (89.2%) males and four (10.8%) females with a mean±SD age of 46.48 ± 12.05 years old. Their alanine aminotransferase average was 137.56 ± 76.46 U/l, the aspartate aminotransferase average was 62.84 ± 58.26 U/l, while international normalized ratio average was 1.79 ± 0.59. Histopathology shown, ballooning degeneration in 28 (75.7%), apoptosis was negative in 12 (32.4%), few in 13 (35.1%), and many in 12 (32.4%). Immunostaining with anti-BCL2 antibodies for apoptotic hepatocytes was negative in 12 (32.4%) and positive in 25 (67.6%). BCL2 expression was significantly higher with ballooning degeneration (P=0.019). BCL2 expression was significantly higher with apoptosis (P<0.001). Alanine aminotransferase, aspartate aminotransferase, and bilirubin levels were significantly higher with positive BCL2 expression (P=0.002, 0.025, and 0.002, respectively) and with positive ischemia/reperfusion injury (moderate or severe changes) (P=0.005, 0.032, and 0.008, respectively).

Conclusion
Liver pathology biopsy remains the ‘gold standard’ for the diagnosis of allograft dysfunction as when the clinical picture, liver enzymes, and imaging parameters are unclear.
Evaluation of sex-determining region Y box 6 and heart development protein with EGF-like domain 1 in differentiating epithelioid mesothelioma from lung adenocarcinoma
Authors: Abd Allah Marwa S. , Mohamed Samy A. , Said Eman M. 
Published: February 2023

Background
Malignant mesothelioma can be difficult to be distinguished from lung adenocarcinoma without immunohistochemistry. However, conventional mesothelial markers until now do not have optimal sensitivity and specificity, necessitating the identification of new markers.

Patients and methods
Sex-determining region Y box 6 (SOX6) and heart development protein with EGF-like domain 1 (HEG1) were evaluated by immunohistochemistry in 55 cases of epithelioid mesothelioma and 50 cases of lung adenocarcinoma. All cases were previously immunostained by calretinin and D2-40. Both sensitivity and specificity for distinguishing epithelioid mesothelioma from adenocarcinoma were calculated.

Results
SOX6 expression was present in 54 (98%) of 55 cases of epithelioid mesothelioma, compared with its expression in only four (8%) of 50 cases of lung adenocarcinoma. The sensitivity and specificity of SOX6 expression for differentiating epithelioid mesothelioma from lung adenocarcinoma were 98.2 and 92.0%, respectively. HEG1 expression was present in 52 (94.5%) of 55 cases of epithelioid mesothelioma, compared with its complete negative expression in all studied cases of lung adenocarcinoma. The sensitivity and specificity of HEG1 for differentiation epithelioid mesothelioma from lung adenocarcinoma were 94.5 and 100%, respectively. The sensitivity and specificity of both SOX6 and HEG1 were higher than those of calretinin and D2-40.

Conclusion
SOX6 and HEG1 may be used as immunohistochemical markers for differentiating epithelioid mesothelioma from lung adenocarcinoma.
Evaluation of the significance of human class I homeobox A13 and STK4/MST1 expression in conventional colorectal adenoma and adenocarcinoma and correlation with clinicopathological parameters (immunohistochemical study)
Authors: Abdel-Aal Ebtehal M. , Soliman Amira El-Sayed 
Published: February 2023

Background
Colorectal carcinoma (CRC) is the third most common cancer in the world. Human class I homeobox A13 (HOXA13) was initially identified as a transcription factor and has an important role in embryonic development and malignant transformation. Mammalian STE20-like kinase 1 (STK4/MST1) encodes a serine/threonine kinase that is the mammalian homolog of the Hippo pathway and plays an important role in controlling cell growth, apoptosis, and organ size.

Aim
This work aimed to evaluate the role of HOXA13 and STK4/MST1 in conventional colorectal adenoma and adenocarcinoma.

Materials and methods
This retrospective study was carried out on 20 cases of conventional colorectal adenoma and 30 cases of conventional colorectal adenocarcinoma. HOXA13 and STK4/MST1 immunostaining was done and assessed for each case. Correlation with the clinicopathological findings and statistical analysis was studied.

Results
In the carcinoma cases, there was a highly significant direct statistical correlation between HOXA13 expression and tumor grade, lymph node metastasis, and TNM stage (P<0.01 for each). Inverse statistical correlation between STK4/MST1 expression and tumor grade, depth of tumor invasion (T), and TNM stage (P<0.01 for each) was found. HOXA13 and STK4/MST1 immunoexpression showed direct highly significant relation with the transition from adenoma to adenoma with dysplasia to adenocarcinoma (P<0.01). There was a highly significant inverse statistical correlation between HOXA13 and STK4/MST1 expression in the studied cases of CRC (P<0.01). According to receiver-operating characteristic curve, both markers were good in the prediction of metastatic potential in the carcinoma cases using the TNM stage as a parameter with a sensitivity of 85%.

Conclusion
HOXA13 was immunohistochemically overexpressed, while STK4/MST1 was downexpressed in progression from colorectal adenoma to adenoma with dysplasia to adenocarcinoma cases. HOXA13 and STK4/MST1 might have a potential role as independent prognostic factors in CRC and may have validity to predict metastatic potential of CRC.