bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peroxisome Proliferator-Activated Receptor α and γ Gene Polymorphisms among South Indian Patients with Diabetic Dyslipidaemia
Authors: Bage IJ , Kamalanathan S , Selvarajan S , Sahoo J , Mathaiyan J , Naik D 
Published: April 2023

Background:
Peroxisome proliferator-activated receptors (PPAR) α and γ genes play an important role in dyslipidaemia of T2DM.

Aims:
To estimate the frequency distribution of PPAR α and γ gene polymorphisms in South Indian T2DM patients with dyslipidaemia compared to healthy controls. Normative frequencies of SNPs were established and compared with data for 1000 genome populations.

Methods:
Eligible 382 cases and 336 age and sex-matched controls were enrolled. Six SNPs in PPARα [rs1800206 C>G (Leu162Val), rs4253778 G>C, rs135542 T>C] and PPARγ [rs3856806 (C>T), rs10865710 (C>G), rs1805192 C>G (Pro12Ala)] genes were selected for genotyping.

Results:
The allele and gene frequencies did not significantly differ between the diabetic dyslipidaemia cases and healthy controls. However, they were significantly different from that of 1000 genome populations except for rs1800206 C>G (Leu162Val) and rs1805192 C>G (Pro12Ala).

Conclusion:
The studied polymorphisms in PPARα and PPARγ genes are not associated with diabetic dyslipidaemia among South Indian patients.
A Questionnaire-Based Prospective Study to Assess Professional and Personal Satisfaction amongst Endocrine Surgeons in India
Authors: Gaurav K , Singh U , Roy S , Anand A , Ramakant P , Kumar S , Sonkar Abhinav Arun 
Published: April 2023

Background:
Endocrine surgery (ES) has been a well-recognised surgical carrier option for trainees across the globe. With the successful running of Magister Chirurgiae (MCh) training programmes at various premiere medical institutions, it is rapidly gaining popularity in India. This study was conducted to assess multiple aspects of practising endocrine surgeons in India such as financial well-being, career satisfaction, and work-life balance.

Materials and Methods:
A questionnaire-based survey was circulated amongst the members of the Indian Association of Endocrine Surgeons. The questionnaire included questions on various professional and personal fronts of practising endocrine surgeons in India such as training in ES, contentment/satisfaction with the field, teaching/training scenario of ES in India and comparison with opportunities outside India, rating in surgical calibre as well as choices regarding change of sector, change of speciality, etc.

Results:
Seventy-three endocrine surgeons participated in the study. 46.6% were ES faculties working in different medical institutes, 26% were consultants in private practice, 16.4% were ES residents training under the MCh curriculum, and 11% were general surgeons practising ES. 35.6% had less than five years of experience, 27.4% had an experience of 5–10 years and 37% had more than 10 years of experience. 79.5% said ES was their first choice. 26% had beforehand exposure to other specialities before joining ES. Academic satisfaction was found to be fulfilling in 54.8%, overall work satisfaction in 71%, surgical work satisfaction in 54.8%, financial satisfaction in 43.8%, and personal life satisfaction in 71.2%. 60.3% felt burnt out once every six months, 35.6% felt it every three months and 4.1% felt the same every month. 61.6% said that it was difficult to balance their personal and professional lives. 61.6% believed that ES training in India was better or at par compared to training outside Indian territories. 58.9% felt their surgical skill calibre was equivalent, while 27.4% claimed to be superior to their peers in other surgical specialities. 63% felt confident by the end of their training period in handling all spectrum of surgeries about ES. 82.2% had no thoughts of changing specialities, whereas 52.1% opted for a change of sector. 61.6% felt there was no gender bias in this field.

Conclusion:
This study is the first of its kind done among practising endocrine surgeons in India, and shows that overall surgeon satisfaction was high, wherein academic surgeons had higher career satisfaction when compared with those private practice surgeons. The quality of life of endocrine surgeons should be improved to ensure better work-life balance which can help in strengthening the cause of ES as a separate super speciality while turning the spotlight on for the younger surgeons to see.
Prevalence of Hyperglycemia in Pregnancy and Related Screening Practices in Rural Dehradun: The First Population-Based Study from Uttarakhand (PGDRD-1)
Authors: Mishra S , Semwal J , Srivastava A , Kumar Mishra S 
Published: April 2023

Aims:
Phase I of the Prevalence of Gestational Diabetes Mellitus in Rural Dehradun (PGDRD) project estimates hyperglycemia in pregnancy (HIP) prevalence and identifies gaps in the utilization of community-related services in rural areas of the Dehradun district (western Uttarakhand); a state where notably no prior population-based study has ever been conducted despite being an Empowered Action Group state for more than two decades.

Methods:
Using a multistage random sampling technique, 1,223 pregnant women locally registered in the rural field practice area of a block were identified. Those requiring HIP screening were subjected to a 2-h 75 g oral glucose tolerance test during the house visit irrespective of their period-of-gestation and last meal timings, diagnosed using the Diabetes in Pregnancy Study Group India (DIPSI) criterion (when indicated). Data were collected by personal interviews using a pretested data collection tool. Statistical Package for Social Sciences version 20.0 was used for analysis.

Results:
The overall HIP prevalence recorded was 9.7% (95% CI: 8.1-11.5%); the majority (95.8%) were GDM followed by overt DIP (4.2%). Less than 1% of the subjects (0.7%) self-reported pre-GDM. Despite this burden, more than three-fourths were never screened for HIP in their pregnancy. Of those tested, the majority availed secondary healthcare facilities. Few even had to bear expenses in private with a very handful being tested free-of-cost by ANM in the community; findings that altogether sharply contrast to those recommended by national protocols.

Conclusion:
Despite the high HIP burden, beneficiaries are unable to utilize community-related universal screening protocols as desired.
Laparoscopic subcutaneous onlay mesh repair for ventral hernia: Our early experience
Authors: Makam Ramesh , Chamany Tulip , Nagur Basavaraj , Bilchod Suhas Satish , Kulkarni Atul 
Published: April 2023

Introduction:
Repair of the ventral hernia is an ongoing challenge in surgery, and a number of surgical techniques have been developed ranging from direct suturing techniques to the use of various mesh types in different planes of the abdominal wall to close the defect and strengthen the musculofascial tissue. Laparoscopic subcutaneous onlay mesh (SCOM) repair is a novel procedure developed recently for ventral hernia repair. We would like to share our experience with laparoscopic SCOM repair.

Patients and Methods:
This is a prospective observational study of patients who have undergone ventral hernia repair at Bangalore Endoscopic Surgery Training Institute and Research Centre from June 2020 to June 2022. A total of 20 patients are included in this study.

Statistical Analysis Used:
The data were entered into MS Excel and analysed.

Results:
A total of 20 patients underwent SCOM repair with a defect size measuring up to 8 cm × 8 cm and a mean operative time of 117 min. Three patients had seroma formation and one patient had surgical site infection. No recurrence is seen after 1-year 2-month follow-up.

Conclusion:
SCOM repair is the newer approach to ventral hernia repair with the advantage over open onlay mesh repair in terms of less pain and better cosmesis. SCOM repair avoids intraperitoneal dissection which may lead to visceral injuries as well as subsequent intraperitoneal adhesions. The acceptance of such surgeries would depend on further long-term studies.
‘Shifting from Anxiety to the New Normal’
Authors: Sivaraman Ganesan , Lakshmanan Jijitha , Paul Britzer , Thulasingam Mahalakshmy , Raghavan Bitty , Raghu Nipun , Raja Kalaiarasi , Saxena Sunil Kumar 
Published: April 2023

Background:
The novel coronavirus pandemic has influenced the working practice of health-care professionals who come across symptomatic and asymptomatic COVID patients in their day-to-day practice. Especially, among HCWs in otorhinolaryngology, with the risk of exposure being high, hence were mandated to use personal protective equipment (PPE).

Materials and Methods:
The change in perceptions and patterns of PPE use throughout the COVID-19 pandemic was studied in detail through interviews conducted among 15 key informants, and the data were analyzed using health belief model in our study.

Results:
A health belief model explains the trajectory of PPE use by otorhinolaryngology health care providers during the COVID-19 pandemic. The course of usage of PPE by otorhinolaryngology health-care professionals during the COVID-19 pandemic was explained through the health belief model. During the initial days of the COVID-19 pandemic, intense perceived severity and susceptibility to COVID infection led to PPE use, and otorhinolaryngology HCWs resorted to higher grade PPEs which gave optimal protection; but in course of time with a better understanding of the natural course of illness, minimal PPEs without compromising HCW safety were used with minimal discomfort. Perceived severity of COVID infection on self and family, health knowledge, influence of peers, and support from the institution encouraged them in using PPEs.

Conclusion:
We found that various aspects of health belief model such as the perceived susceptibility, perceived severity of the disease, perceived barriers and benefits in PPE use, self-efficacy, health-related knowledge, and the cues to action influence PPE use among otorhinolaryngology HCWs. The key findings can be applied in behavior change models to promote the use of PPE in the hospitals, especially during the time of pandemic.
Psoriasis in Kaduna, North-West Nigeria
Authors: Yahya Husain 
Published: April 2023

Background:
Psoriasis is a chronic inflammatory skin disease which may be associated with joint, cardiovascular, metabolic or psychiatric disease. Countries in North America, Northern Europe and Australia have the highest burden of disease while those in Asia, South America and Africa, the lowest. We report our experience of psoriasis in Kaduna, Nigeria, over 20 years and compare this with previous reports in the same area and in other parts of Nigeria and Africa.

Objective:
To report the relative incidence, clinical presentation, severity and associations of psoriasis seen over 20 years.

Methods:
A retrospective review of records of patients with psoriasis seen at two outpatient dermatology clinics in Kaduna, North-West Nigeria, over 20 years.

Results:
Diagnosis of psoriasis was made in 218 of 39,037 (0.6%) patients with new skin disease: Mean age 35.2 years, range (6 months to 80 years), 60% <40 years, males constituted 64.2%. Mean age of onset was 30.5 years with a quarter developing psoriasis before age 20 and 71.4% before 40 years. Psoriasis presented earlier in females than males (mean age of onset 27.6 vs. 32.2 years,P= 0.052) but was less severe. Psoriasis types were: Plaque 88.1%, guttate 6%, erythrodermic 4.6% and sebopsoriasis 0.9%. Only four patients had joint disease and other associations were infrequent. Overall, 80.3% had mild psoriasis and 13.2% had a family history.

Conclusion:
Psoriasis remains a rare and mild disease in Kaduna and is infrequently associated with joint and other systemic disease but similar in other respects to the condition elsewhere.
Pattern and Prevalence of Dental Anomalies among a Paediatric Population in Lagos, Nigeria
Authors: Olatosi Olubukola O. , Oyapero Afolabi , Akinwande Kehinde O. , Ayedun Oladipupo Solomon , Aladenika Emmanuel Temitope , Obe Olorunfemi I. 
Published: April 2023

Background:
Dental anomalies are craniofacial abnormalities in the size, structure or number of the teeth. This study was conducted to assess the prevalence of dental anomalies among children aged 0–16 years attending the Paediatric Dental Clinic at the Lagos University Teaching Hospital, Lagos, Nigeria.

Methods:
A cross-sectional design was used and data were obtained from the dental records of the Dental Clinic from January 2014 to August 2019 by two calibrated examiners, who are co-authors of the manuscript. To test for statistical differences, Chi-squared test was utilised for the categorical variables. The prevalence of the different dental anomalies was estimated and presented with frequencies.P< 0.05 was considered statistically significant.

Results:
Among the 6175 patients' dental records reviewed, 50.85% (n = 3150) were male and the highest proportion of 45.4% (n = 2807) were aged between 6 and 10 years, with a mean age of 8.62 ± 3.85 years. A total of 1090 (17.52%) had dental anomalies; 465 (7.53) anomalies were in the maxilla, 263 (4.6) were in the mandible while 360 (5.83) were in both. The most common anomaly was hypoplasia 550 (9.06%), followed by retained primary tooth 546 (8.84%) and hypodontia 84 (1.36%). Dentinogenesis imperfecta 1 (0.02) and transposition 1 (0.02) were the least prevalent anomalies. Retained primary teeth (5.8%) and the cusp of Carabelli (0.4%) were slightly more prevalent among males. However, females had a higher prevalence of natal/neonatal teeth (0.4%), fusion/germination (0.4%), hypodontia (1.5%) and peg-shaped lateral incisors (0.9%).

Conclusion:
Dental anomalies' prevalence in this study was 17.52%, with a higher occurrence of anomalies in the maxilla. Hypoplasia was the most prevalent anomaly, after which was retained primary tooth, then hypodontia. Prompt diagnosis and preventive interventions are crucial for the appropriate management of these dental anomalies.
Anthropometric Measurements of Term Babies Delivered in a Mission Hospital in Southwest Nigeria
Authors: Olafimihan Victoria Iyabo , Ariba Adekunle Joseph , Florence Dedeke Iyabode Olabisi 
Published: April 2023

Background:
Babies birth anthropometric measurements are useful for retrospective assessment of foetal in utero health status, anticipatory care and growth monitoring. At community level, measurements other than birth weight (BW) may help predict low BW (LBW).

Aim:
The aim of the study was to determine the mean anthropometric measurements of term babies, its comparability with standard values, acceptable cutoff and surrogate for LBW.

Materials and Methods:
A cross-sectional study involving 257 term babies delivered by booked mothers at the Sacred Heart Hospital Abeokuta and selected by systematic random sampling. BW, occipitofrontal circumference (OFC), chest circumference (CC), mid-upper arm circumference (MUAC) and crown-heel length (CHL) were measured, and data were analysed using SPSS version 21 with significantP< 0.05 and confident interval of 95%.

Results:
Mean BW, CC, OFC, CHL and MUAC were 3.25 ± 0.47 kg, 33.32 ± 1.98 cm, 34.7 ± 1.93 cm, 48.16 ± 2.87 cm and 11.57 ± 1.41 cm, respectively, with no significant mean difference between male and female babies. The mean OFC was higher than the national standard, World Health Organization Multicentre Growth Reference Study (WHO-MGRS) and INTERGROWTH-21. The mean cutoff for LBW was OFC – 31.89 cm, CC – 29.56 cm, CHL– 43.33 cm and MUAC – 9.35 cm (P = 0.000) with OFC being the best surrogate of LBW at Sensitivity, Specificity and Degree of Accuracy/area under the curve of 66.7%, 97.6% and 82.1% respectively.

Conclusions:
LBW babies had lower mean anthropometric cutoff values at variance from the WHO-MGRS and INTERGROWTH-21. Mean OFC was higher than both standards reflecting the need for cautious interpretation to prevent misdiagnosis of macrocephaly. We recommend OFC as an alternative for predicting LBW when access to weighing scale is a challenge.
Tolerance and Acceptance for Unsedated Diagnostic Upper Gastrointestinal Endoscopy in Kaduna, North-West Nigeria
Authors: Yahya Husain , Umar Halima , Shekari Bulus Timothy , Sani Kalli , Yahya Muhammad Husain 
Published: April 2023

Background:
Upper gastrointestinal endoscopy (UGIE) using pharyngeal anesthesia, with or without sedation to improve tolerance and acceptance, is now standard practice but the unsedated examination is easier to perform, costs less and is associated with fewer complications. It is, therefore, attractive in resource-limited settings like sub-Saharan Africa but studies about tolerance and acceptance of unsedated UGIE there are limited.

Objective:
The objective of this study was to report the tolerance and acceptance of unsedated UGIE in a tertiary institution in Kaduna, Nigeria.

Methods:
Consecutive patients referred for diagnostic UGIE were requested to report the overall level of discomfort for the procedure on verbal and visual analogue scales and to indicate whether they would accept the procedure in the future. Their pulse rate, oxygen saturation and blood pressure were monitored.

Results:
Of 306 patients (mean age: 45.5 years, 39.2% <40 years, 57.5% of females), 51.3% reported no or mild discomfort and only 5.6% reported severe and intolerable discomfort. Overall, 232 (75.8%) tolerated the procedure well and 229 (79.5%) accepted to have the same procedure in the future. Patients <40 years and those with secondary/post-secondary education were significantly less likely to tolerate the procedure well than older patients (81.1% vs. 87.9%,P= 0.006) and those with lower education (72.7% vs. 86.2%,P= 0.032), respectively. 79.5% accepted to have the procedure in the future, with males significantly more so than females (86.9% vs. 74.4%,P= 0.019).

Conclusion:
Most patients undergoing unsedated diagnostic UGIE in Kaduna, Nigeria, tolerated the procedure well and accepted to have the same procedure in the future.
Can the Tibial Length Predict the Size of Tibial Component of Total Knee Arthroplasty?
Authors: Akinmokun Olasode Israel , Alabi Eyitayo Oluwasakin , Enweluzo George Okwudilichukwu , Balogun Akindele Rafiu , Oyebiyi Ismail Abidemi 
Published: April 2023

Background:
Total knee arthroplasty (TKA) is performed worldwide. TKA is performed to relief pain, correct deformities and improve mobility in patients with debilitating diseases of their knee joints. Templating is done as pre-operative planning for TKA. Certain parameters, such as shoe size, had been studied as predictor (s) for implant size. This study aimed to determine if the tibial length (TL) can also be as a predictor of a tibial component of TKA.

Materials and Methods:
TL and tibial plateau width (TPW) measurements were done on dry adult tibiae. Proximal tibiae were traced on tracing paper, to obtain anterior–posterior and lateral tracings. Length of tracings confirmed with measurement on dry bones. A TKA template, converted to 100% scale was used to estimate the tibial baseplate by two orthopaedic surgeons.

Results:
A total of 51 matured, non-sexed, non-paired tibiae were studied. There was a statistically significant positive relationship between the TL and the TPW (P = 0.0001). Furthermore, a statistically significant positive relationship was also observed between the TL and the tibial implant baseplate (P = 0.0001). The study showed that a particular range of tibia length will accommodate certain sizes of the tibial implant baseplate.

Conclusion:
The tibia length can be used as a predictor of the size of tibial baseplate of TKA.
Ultrasonographic Foetal Head Circumference and Cheek-to-Cheek Diameter at Term as Predictors of Labour Outcomes
Authors: Agbaje Michael Ademola , Alao Abayomi Ibukun , Owonikoko Kola Musliudin 
Published: April 2023

Background:
The clinical uses of ultrasonography have varied and increased over time, especially the ability of ultrasonographic measured parameters to predict the outcomes of labour. The proper understanding of the association between these ultrasonographic parameters, mode of delivery, adverse maternal and foetal outcomes will further improve patient counselling as well as the planning of intrapartum care.

Aim:
The study explored the ultrasonographic measurement of foetal head circumference (HC) and cheek-to-cheek diameter (CCD) at term as predictors of labour outcomes.

Methodology:
Eligible pregnant women at term were recruited from the antenatal clinic and had obstetric ultrasound scans done with HC and CCD measured. Maternal and foetal outcomes were measured and included progress in labour, obstetric lacerations, mode of delivery and suspected foetal distress. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 20.

Results:
One hundred and thirty-two patients were recruited into the study. Foetal HC measurements ≥35 cm were closely associated with caesarean delivery odds ratio - 2.40 (95% confidence interval - 1.02–5.66.P= 0.046). Neither CCD nor CCD/HC ratio was predictive of the modes of delivery. The occurrence of perineal lacerations and poor progress of labour were observed more frequently with increasing HC and CCD.

Conclusions:
HC performed well in predicting caesarean delivery as well as perinatal outcomes among parturients. The ultrasonographic measured HC (≥35 cm) is associated with a higher incidence of both obstetric interventions for poor progress of labour and adverse perinatal outcomes in comparison to CCD. The association between HC and labour dystocia was found to be linear. The CCD did not perform well as a predictor of the mode of delivery.
Impact of Corona Virus Disease 2019 Pandemic on Paediatric Surgery in a Sub-Saharan Tertiary Hospital
Authors: Seyi-Olajide Justina O. , Bode Christopher O. , Ihediwa George C. , Elebute Olumide A. , Alakaloko Felix M. , Ladipo-Ajayi Oluwaseun A. , Ademuyiwa Adesoji O. 
Published: April 2023

Background:
The impact of the corona virus disease 2019 (COVID-19) pandemic on global health, has reached far beyond that caused by the disease itself. With ongoing mutations and the emergence of new strains of the virus alongside repeated waves of the pandemic, the full impact of the pandemic is still evolving and remains difficult to predict or evaluate. In paediatric surgery, it has led to significant disruptions in patient care, the extent and consequence of which are not fully documented in Nigeria.

Aim:
This study aims to evaluate the impact of COVID-19 on services, training and research in a busy paediatric surgery unit during the initial 3-month period of the COVID-19 pandemic lockdown.

Methods:
This study was an ambispective evaluation of the preceding 3 months before lockdown and the initial 3 months of lockdown. Clinic cancellations, elective and emergency surgeries, delays in access, extra cost of care to patients, impact on training and research, and the psychologic impact of the pandemic on staff and guardians were evaluated.

Results:
During the 3-month lockdown period, an estimated 78 new cases and 637 follow-up cases could not access care. Ninety-seven elective surgeries in 91 patients were postponed. Two (2.2%) patients' symptoms progressed. All emergency patients received care. Out-of-pocket expenditure increased averagely by $124. The pandemic contributed to delays in seeking (13%), reaching (20%) and receiving care (6%). Trainee participation in surgeries was reduced and academic programmes were suspended. Five staff were exposed to the virus and 3 infected.

Conclusion:
Paediatric surgery has been negatively impacted by COVID-19. Efforts must focus on planning and implementing interventions to mitigate the long-term impact.