bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hypogonadism among patients with transfusion-dependent thalassemia: a cross-sectional study
Authors: Mahwi Taha O. , Rashid Zagros G. , Ahmed Shaho F. 
Published: August 2023

Introduction:
Patients with thalassemia major are liable to have complications from blood transfusion and iron excess despite using iron-chelating agents. It is common to have endocrine complications in these patients. Hypogonadism is one of the most common complications in thalassemic patients. Early detection and treatment are essential to restore puberty and prevent complications from hypogonadism.

Patients and methods:
The authors conducted this cross-sectional study in the Kurdistan Region of Iraq, from 1 July 2022, to 1 December 2022. Eighty patients with β-thalassemia major who were referred to the endocrinology clinic were enrolled. The patients were evaluated sequentially, starting with a history, followed by a clinical examination and laboratory tests related to endocrine disease. Those who met the inclusion criteria were enrolled in the study, while the others were excluded.

Results:
Out of 80 patients with major thalassemia who were referred to the endocrinology clinic, 53 (66.3%) were female, and 27 (33.7%) were male, with a mean (SD) age of 24.86±7.66 (14–59) years. Fifty-five (68.75%) of them had hypogonadism, three patients (3.8%) had hypothyroidism, while two (2.5%) had hypoparathyroidism. Five patients (6.3%) had diabetes. None of the patients had adrenal insufficiency. The mean ferritin level in thalassemic patients with hypogonadism and thalassemic patients without hypogonadism was 2326±2625 ng/ml vs. 1220±2625 ng/ml.

Conclusion:
To minimize the risk of endocrinopathy in patients with thalassemia major, they should receive blood transfusions regularly and initiate chelating agents early, because the leading cause of endocrinopathy in thalassemic patients is related to the severity of anemia and iron overload.
Surgical characteristics of appendectomy in the eastern region of the democratic republic of congo: a cross-sectional study
Authors: Masimango Gaston , Cakwira Hugues , Oduoye Malik O. , Onesime Jones , Otobo Daniel D. , Kibukila Fabrice , Banga Styves , Akilimali Aymar , Suvvari Tarun K. , Kyaruzi Victor M. , Rehman Ibad ur , Bavurhe Rodrigue F. , Nyakio Olivier 
Published: August 2023

Background:
Appendectomy is a surgical procedure performed on a patient with acute appendicitis and is often performed by surgery and performed in an emergency. The authors have carried out this study, which aims to describe the surgical characteristics of appendectomies.

Methods:
This retrospective, descriptive, and documentary cross-sectional study was conducted from October 2021 to October 2022. Within this time ~591 acute abdominal surgical procedures were performed, including 196 appendectomies performed in the general surgery department.

Results:
This study focused on 196 appendectomies performed out of a total of 591 surgeries performed, with an incidence of 34.2%. 51 cases (26%) for the age group between 15 and 20 years, 129 cases (65.8%) of women participated in the appendectomy. 133 (67.8%) acute appendicitis, 48 (24.5%) appendicular abscess and 15 (7.7%) appendicular peritonitis were indications for appendectomies. For the American Society of Anesthesiologists (ASA) score: for the ASA I, 112 (57.1%) of the patients had no conditions other than those requiring surgery (appendectomy). For the Altemeier classification, the authors recorded 133 (67.9%) own surgeries. 56 (28.6%) surgical site infections followed by 39 (19.8%) inflammation (swelling and redness), 37 (18.8%) pain, 24 (12.4%) purulent peritonitis, 21 (10, 7%) postoperative hemorrhage and 19 (9.7%) paralytic ileus and 157 (80.1%) patients benefited from medical treatment.

Conclusion:
The low incidence of complications related to laparotomy appendectomy has been reduced to a minimum thanks to the respect of sanitary measures and the quality of the technique.
Chronic contained ruptured abdominal aortic aneurysm with a rare presentation of lower limb neuropathic claudication: a report of two cases
Authors: Hariri Omar , Al Laham Omar , Mohammad Ammar 
Published: August 2023

Introduction and importance:
A vertebral body erosion that takes place due to a chronic contained rupture of an abdominal aortic aneurysm is an especially rare vascular pathology that comprises less than 5% of all causes of vertebral body erosion. Chronic contained rupture of an abdominal aortic aneurysms are primarily observed in hemodynamically stable patients whose chief complaint is lower limb neuropathic pain. This entity is extremely misleading and this results in delayed management of those patients increasing the morbidity and mortality rates.

Case presentation:
We present the two cases of 62-year-old and 65-year-old males. Preoperative radiology for each patient showed an infrarenal aortic aneurysm with a retroperitoneal hematoma in contact with the lumbar vertebral bodies and psoas muscle. The draped aorta sign was evident in both cases.

Clinical discussion:
A curative surgical intervention was accomplished for both patients, respectively. This was achieved through the removal of the existing hematomas that were compressing the vertebrae in addition to the complete isolation and resection of the respective abdominal aortic aneurysms along with thorough reconstruction of the aortoiliac spindles with patent synthetic grafts to ensure the patency of the preexisting vascular axis.

Conclusion:
A contained rupture of an abdominal aortic aneurysm is a rare occurring vascular pathology that manifests with nonspecific symptoms, such as femoral neuropathy and lower back pain proportionate to the degree of the level of erosion of the affected lumbar vertebrae. This will increase the possibility of misdiagnosis and delays in treatment. Such a life-threatening vascular emergency should be timely detected and treated to avoid its complications and patient mortality.
Dynamic interaction of obesity, age, MCP-1 Level, and ACE-1 gene with the severity of knee osteoarthritis: a cross-sectional study
Authors: Mustari M. Nasser , Massi Muh. Nasrum , Usman Muhammad A. , Fikry Achmad , Bukhari Agussalim , Idris Irfan , Zainuddin Andi A. , Adnan Endy , Bakri Syakib , Hatta Mizwar 
Published: August 2023

Introduction:
The risk factors most strongly associated with knee osteoarthritis (OA) are old age and obesity. However, few studies have evaluated the interaction between aging and obesity in conjunction with inflammatory markers and knee OA severity as part of a complete assessment of knee OA management. Therefore, this study aims to evaluate the interaction between obesity, age, inflammation [including the I/D polymorphism of angiotensin converting enzyme-1 (ACE-1)], and the severity of knee OA.

Methods:
A total of 80 knee OA patients were included in this cross-sectional study. The severity of knee OA was determined based on the Kellgren–Lawrence system. All patients underwent physical and radiological examination; monocyte chemoattractant protein 1 (MCP-1) markers were measured. The parameters of the ACE-1 gene were examined with sequencing DNA.

Results:
There was a significant relationship between age and severity of knee OA (P=0.007), with subjects aged greater than or equal to 65 having a 3.56-fold higher risk of developing moderate to severe OA than subjects aged less than 65. There was a significant difference between body weight and knee OA severity (P=0.026), in which subjects weighing greater than or equal to 60 kg had 3.14 times the risk of experiencing severe knee OA. Multivariate regression analysis indicated that age was the strongest independent variable for knee OA severity compared with body weight. MCP-1 levels were significantly higher in mild knee OA than in moderate to severe knee OA. The DD genotype of the ACE-1 gene increases the risk of severe knee OA by four times in subjects aged greater than or equal to 65 compared to subjects aged less than 65. However, the DD genotype of the ACE-1 gene does not increase the risk of severe knee OA in subjects weighing greater than or equal to 60 kg.

Conclusion:
While obesity and age were found to be associated with the severity of knee OA, age emerged as the independent risk factor for knee OA severity. Furthermore, MCP-1 levels were significantly higher in cases of mild knee OA compared to severe knee OA. It was observed that the DD genotype of the ACE-1 gene increases the risk of severe knee OA in individuals aged 65 years or older.
Chikungunya outbreak in Africa: a review of the literature
Authors: Chinedu Eneh Stanley , Uwishema Olivier , Nazir Abubakar , El Jurdi Elissa , Faith Olanrewaju Omotayo , Abbass Zahraa , Mustapha Jolayemi Mubarak , Mina Nour , kseiry lea , Onyeaka Helen 
Published: August 2023

Introduction:
The Chikungunya virus (CHIKV), transmitted via mosquitoes, exhibits clinical manifestations ranging from headaches, myalgia and arthralgia to debilitating systemic malfunctions. Endemic to Africa, CHIKV has seen an increase in cases since it was first recorded in 1950. There has recently been an outbreak in numerous African nations. The authors aim to review the history and epidemiology of CHIKV in Africa, current outbreaks, strategies adopted by governments and/or international organisations to mitigate such an outbreak, and future recommendations that can be employed.

Methodology:
Data were collected from medical journals published on Pubmed and Google Scholar, and from the official World Health Organisation, African and United States of America’s Centres for Disease Control and Prevention websites. All articles considering CHIKV in Africa, including epidemiology, aetiology, prevention and management, were sought after.

Results:
Since 2015, the number of Chikungunya cases in Africa has increased, reaching the highest values ever recorded, especially in 2018 and 2019. Even though numerous vaccination and therapeutic intervention trials are still ongoing, no advancement has been made so far, including drug approval. Current management is supportive, with preventative measures, such as insecticides, repellents, mosquito nets and habitat avoidance, paramount to halting disease spread.

Conclusion:
In light of the recent CHIKV outbreak in Africa, local and global attempts are re-emerging to mitigate the eruption of the case of the lack of vaccines and antivirals, controlling the virus may be an arduous feat. Improving risk assessment, laboratory detection and research facilities should be a priority.
Evaluation of the efficacy of horizontal distraction osteogenesis using expansion screws in the repair of the acquired jaw bone defects
Authors: Haddad Ibrahim , Khalil Ali 
Published: August 2023

Background:
Restoration of the segmental defects of the maxilla presents a reconstructive dare to obtain a perfect osseous form and height. A variety of prosthetic and surgical bone grafts exists, that produces less than optimal results. Bone transport distraction is a dependable procedure in several maxillofacial bone defects reconstruction techniques. This study aimed to evaluate the effectiveness of horizontal distraction osteogenesis (DO) using expansion screws for the treatment of atrophic and deficient bone, which is caused by acquired malformations.

Material and methods:
A total of eight patients ( age 17–36 years) who came with atrophy of the maxilla were treated by horizontal DO. The used device consisted of two parts: one was an orthodontic expander and the other was a screw-ring. The expansion screws were set on the transport bone, which was osteotomized and fixed to the segments using microscrews. Radiographical documentation of the patients was obtained with cone beam computed tomography prior to the surgery and after 4 months of the distraction phase.

Results:
The average of the actual bone gain at the end of the consolidation period was 7 mm (range 5–9 mm). Intraoral DO failed in one patient. The average bone density in the distraction gap after 4 months of the DO was 460.40. The average bone density of the bone defect region after 4 months of the DO was 487.90

Conclusion:
Our results confirm that horizontal DO using expansion screws is a predictable and effective regenerative procedure for patients with acquired bone defects in the jaw.
Endoscopic septoplasty versus conventional septoplasty for nasal septum deviation: a systematic review and meta-analysis of randomized clinical trials
Authors: Besharah Bayan O. , Alharbi Hussain A. , Abu Suliman Omar A. , Althobaiti Hazem K. , Mogharbel Ahmed M. , Muathen Sumaiya H. 
Published: August 2023

Background:
Although conventional septoplasty is widely used to treat nasal septum deviation, it increases morbidity due to poor visualization, poor illumination, the need for nasal packing, and difficulty in evaluating of the exact pathology. These drawbacks are also encountered in endoscopic septoplasty. Our study aimed to compare the treatment and complication outcomes of conventional and endoscopic septoplasty.

Methods:
The authors searched five electronic databases for relevant clinical trials. The records were screened for eligibility. Data were extracted from the included studies. Outcomes were pooled as risk ratios (RR) or mean differences with 95% CIs using RevMan ver.5.4.

Results:
Our study included 13 randomized clinical trials with 735 patients. Our analysis revealed that endoscopic septoplasty was significantly (P<0.05) superior to conventional septoplasty for postoperative nasal obstruction relief, intraoperative and postoperative hemorrhage, and mucosal adhesion and synechiae across both long-term and short-term follow-ups. The following pooled RR values were found in short-term follow-up periods: [RR=1.20, 95% CI:=(1.09,1.32)]; [RR=0.27, 95% CI=(0.14,0.54)]; and [RR=0.16, 95% CI=(0.08,0.32)], respectively. Regarding persistent septal deviation and septal tear, endoscopic septoplasty had the upper hand only in short-term follow-up periods [RR=0.30, 95% CI=(0.17,0.53)] and [RR=0.26, 95% CI=(0.15,0.46)], respectively.

Conclusion:
Our analysis revealed that endoscopic septoplasty was significantly superior to conventional septoplasty in postoperative nasal obstruction relief rate and reducing the risk of intraoperative and postoperative hemorrhage, mucosal adhesion and synechiae, persistent septal deviation, septal tear, and surgery duration.
Arthroscopic management of recurrent synovial chondromatosis of the hip: a case report
Authors: Chaudhary Aashutosh , Dahal Amartya , Shrestha Rohit , Khadka Sushant Kumar , Maharjan Sagar , Basi Ashkal , Acharya Shreedhar Prasad 
Published: August 2023

Introduction and importance:
Synovial chondromatosis is a rare condition characterized by the chondral proliferation of synovium forming loose bodies which can lead to pain, swelling, and decreased range of movement of the affected joint.

Case presentation:
Here the authors report a case of eighteen years lady with recurrent hip synovial chondromatosis who was treated previously with hip arthrotomy and loose bodies removal and now she underwent arthroscopic loose bodies removal with partial synovectomy.

Clinical discussion:
In comparison to arthrotomy of the hip, arthroscopic management is a minimally invasive surgery that is associated with decreased postoperative pain, earlier improvement in range of motion, a shorter course of rehabilitation, and overall lower morbidity.

Conclusion:
Thus, the authors recommend arthroscopic removal of the loose bodies and partial synovectomy for the management of synovial chondromatosis of the hip.
Chest wall mass as a sign of ignored hepatocellular carcinoma in an alcoholic cirrhotic patient: a case report
Authors: Poddar Elisha , Shrestha Suraj , Thapa Raju , Subedi Sudhan , Pathak Niharika , Khadayat Ramesh , Regmi Pradeep 
Published: August 2023

Introduction and importance:
Bone metastasis of hepatocellular carcinoma (HCC) is usually seen in the course of advanced intrahepatic HCC. Isolated bone metastasis as an initial manifestation of HCC is uncommon.

Case presentation:
The authors report a case of a 68-year-old male with a history of chronic alcohol consumption who presented with epigastric pain, abdominal distension, and a hard, tender lump on the right posterolateral aspect of his back. Investigation revealed HCC with isolated metastasis to the posterior thoracic wall.

Clinical discussion:
HCC usually develops secondary to chronic hepatitis B and C infection in the background of chronic liver disease. Common presenting symptoms of bone metastasis include local pain, neurological manifestations, palpable subcutaneous masses, and pathological fractures. An immunohistochemistry analysis is important to differentiate HCC from non-HCC metastasis in patients without known underlying HCC. Treatment is often directed towards palliative care as the prognosis is poor.

Conclusion:
An isolated rib mass can be an initial presentation of metastatic HCC. Thus, HCC with bone metastasis should be considered in the differential diagnosis in patients presenting with painful swelling in the thoracic region.
Treatment of an ossifying fibroma of the mandible with endodontic microsurgery and grafting with a biphasic calcium sulfate material: a case report
Authors: Dudeck Damian , Warmusz Oliwia , Reichman-Warmusz Edyta , Kurtzman Gregori M. 
Published: August 2023

Introduction:
A significant percentage of lesions of endodontic origin require surgical management due to the possible diagnosis of odontogenic cysts and tumors in the maxilla and mandible. Ossifying fibroma is a benign fibro-osseous lesion that typically presents as a painless, slow-growing, and expansile lesion that appears as a well-demarcated lesion with a variable degree of internal calcification on radiography. Treatment results in a large osseous defect, utilization of a graft to fill the void accelerates healing and prevents complications that may result from failure to fill by the host response.

Case presentation:
Following endodontic surgery placement of osseous graft material via Guided Tissue Regeneration to fill the defect aids to accelerate fill of the defect on a healthy 26-year-old female patient. A case discussing the one-step treatment of an ossifying fibroma of the anterior part of the mandible following endodontic microsurgery with associated retrograde fill of the apex, then site grating with biphasic calcium sulfate (Bond Apatite®) used in regeneration of the osseous defect related to the lesion and resulting surgery.

Clinical discussion:
Histologically, the ossifying fibroma is dominated by connective tissue containing cell rich areas with a few fragments of fibrosis. Moreover, in the connective tissue numerous small fragments of spongy and compact bone with areas of partial necrosis present and a significant number of inflammatory cells are observed. Surgical removal of the cyst with thorough curettage of the osseous walls and grafting of the defect provides predictable healing and the desired clinical results sought. Utilization of the biphasic calcium sulfate graft material allows the elimination of the need to overlay the area with a membrane before the flap due to its hard set and the prevention of soft tissue ingrowth into the graft material during the healing phase. Additionally, the hard set of the material allows tenting of the area to maintain the desired volume and ridge contour. Conversion of the graft material depending on the volume placed to host bone occurs over a 3–6 month period.

Conclusion:
The case report presented, as well as the authors experience mimics the literature on biphasic calcium sulfate in its use as an osseous graft material and is an effective method for the repair of osseous defects that result from the removal of tumors and cysts of the maxilla and mandible. Treatment of an ossifying fibroma is an ideal application of the use of this biphasic calcium sulfate material allowing tenting of the surgical site over the defect created after cyst removal without the need for resorbable collagen membranes. This simplifies its use and decreases material costs that may hamper patient acceptance of treatment without a decrease in expected clinical results.
Contemporaneous and upcoming trends in immunotherapy for prostate cancer: review
Authors: Saleem Samra , Rashid Abu B. , Shehzadi Sarma , Mumtaz Hassan , Saqib Muhammad , Bseiso Anan , Villasenor Alexis V. , Ahmed Adeel , Sonia Shamsun N. 
Published: August 2023

Prostate cancer (PCa) is the most common cancer in men worldwide. It affects more than 1.4 million men worldwide and kills up to 37 5000 people. PCa is routinely managed with chemotherapy and androgen deprivation therapy, but the success rate of these treatments is unsatisfactory. Immunotherapy is a novel method of treating different types of cancers, and it utilizes the body’s own immune system to fight cancer. Different types of cancer respond differently to immunotherapy, with some showing excellent responses, while others do not show very satisfactory responses. PCa is known to be an immunologically cold tumor, such that conventional immunotherapy does not work as effectively as it works in other cancers. In the past decade, multiple studies and trials have been conducted to test different types of therapies, ranging from immune checkpoint inhibitors to anticancer vaccines to anticancer cytokines. Even after many studies, there is still a drug to be discovered that can completely cure any stage of PCa. Recent immunotherapeutic drug trials have started using immunotherapy in conjunction with chemotherapy and radiotherapy and have shown promising results. In this paper, the authors present a comprehensive overview of the currently used immunotherapeutic drugs as well as emerging immunotherapies, including modalities of combination immunotherapy with radiotherapy and chemotherapy. This review can help readers gain the latest knowledge about emerging trends in the current immunotherapy landscape for the treatment of PCa, as well as a general overview of the already used immunotherapy drugs for PCa.
Accessible Technology Course Design Practices for Inclusivity in Nursing Education
Authors: Kotcherlakota Suhasini , Rejda Patrick , Stamler Lynnette Leeseberg , Kupzyk Kevin 
Published: August 2023

Background:
Nursing students are diverse in culture, abilities, and challenges. Universal Design for Learning is a logical and social model to support diverse learning methods. Accessibility tools help measure the efficacy of faculty efforts to make nursing courses accessible to all.

Purpose:
The study examines using accessibility software to measure faculty improvements and student engagement in nursing courses over 2 academic semesters.

Methods:
One hundred courses were analyzed 1 year apart for accessibility improvements by nursing faculty.

Results:
Course accessibility scores significantly rose year after year in almost all courses. Student usage also increased significantly. Lessons learned are presented.

Conclusion:
Accessibility improvements are worthwhile for enhancing inclusion in nursing programs and student engagement.