bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parent-Directed use of Over-the-Counter Medications and Complementary and Alternative Medicine Therapies among Pediatric Patients: A Cross-Sectional Study
Authors: Seth Shreyasi , Dubey Ashok Kumar , Maheshwari Nidhi 
Published: August 2023

ABSTRACT

Objective:
The use of over-the-counter (OTC) drugs and complementary and alternative medicines (CAM) as initial options by parents is common in the pediatric population. Despite the widespread use of parent-directed medication (PDM) among the pediatric population, we have scarce data in the Indian context. This study was done to assess the PDM practices and its determinants in the Indian population.

Methods:
It was a descriptive cross-sectional study assessing a representative sample of 284 parents of pediatric patients visiting the pediatrics department of a tertiary care hospital.

Findings:
Majority (64.08%; 182 out of 284) of the parents agreed to have used some form of PDM in the past 3 months. While higher socioeconomic status and having 2 or more children were associated with higher practice of PDM (P < 0.05), it was similar between educated or uneducated parents, rural or urban backgrounds, and nuclear or joint families (P > 0.05). CAM was the most commonly used option (58.12%; 161 out of 277), followed by OTC conventional allopathic medications (41.88%; 116 out of 277). Homeopathic medicines were the most preferred alternative therapy under the Alternative Medical System Category of National Centre for Complementary and Alternative Medicine. Majority of parents (71.43%; 130 out of 182) were confident that the treatment chosen could not harm the health of their children and they attributed time constraints or availability of prior prescriptions as reasons for such practice.

Conclusion:
PDM is a widespread phenomenon in the Indian pediatric population. The parents as well as the prescribers need to take a more balanced, practical, and judicious approach toward medications given to a child.
Does Serratiopeptidase prevent thoracic surgery in patients of hydropneumothorax of tubercular aetiology?
Authors: Shukla Amitabh D. , Agarwal Vaidehi 
Published: August 2023

ABSTRACT

Background:
Tubercular hydropneumothorax is commonly seen in Indian hospitals. Anti-tuberculosis drugs and intercostal drainage tube (ICD) insertion are the mainstays of treatment. But many patients have to be referred to thoracic surgery for surgical management. This study aims to evaluate the role of serratiopeptidase in successful resolution of tubercular hydropneumothorax and avoidance of thoracic surgery.

Methods:
We conducted a retrospective observational cohort study on 28 patients that were admitted to extrapulmonary TB ward of our hospital. All patients were given anti-TB drugs according to national guidelines and underwent ICD tube insertion. Out of 28 patients recruited, 19 suffering severe chest pain received serratiopeptidase containing analgesic tablets and nine patients of the control group not having severe chest pain received non-serratiopeptidase containing analgesic tablets. Both groups were compared on the basis of successful ICD tube removal. The results were analysed using Chi-square statistic with Yates correction.

Results:
Of the 19 patients in the intervention group who received serratiopeptidase, 16 had successful recovery while three had to undergo thoracic surgery. Of the nine patients in the comparison group, only one had a successful recovery while the other eight had to be referred to thoracic surgery with ICD tube in situ. The outcome showed a statistically significant difference between the two groups, in terms of ICD tube removal and avoidance of thoracic surgery, with a P value of < 0.001.

Conclusion:
We conclude that the addition of serratiopeptidase to anti-tubercular drugs regimen can lead to better clinical outcomes and avoidance of thoracic surgery, in patients of tubercular hydropneumothorax.
Rapid diagnosis of TB using Aptamer-based assays for Mycobacterium tuberculosis antigens in children and adolescents
Authors: Bethu Rajesh , Mittal Hema Gupta , Sharma Tarun K. , Shulania Anuradha , Sharma Neera , Rangarajan Shmitha , Jain Prerna 
Published: August 2023

ABSTRACT

Background:
Despite advances establishing microbiological evidence of tuberculosis (TB) is still a concern in children due to the limitation of availability of sample and predominance of extrapulmonary TB, there is unmet need for diagnostic tests which are low cost, rapid and sensitive and specific.

Methods:
This study evaluated the utility of aptamer-based assay for detecting mycobacterium tuberculosis antigens HspX and MPT 64 in rapid diagnosis of TB in children up to 18 years of age in a tertiary medical college. A total of 100 children were sequentially enrolled with presumptive pulmonary (n = 52 and extrapulmonary n = 48) TB based on clinico-radiological characteristics. The samples were evaluated with ALISA technique for TB antigens and compared with the results of ZN microscopy, GeneXpert and mycobacterial culture MGIT.

Results:
The enrolled children had mean age (11.7 + 4.4 years) with both pulmonary (n = 52) and extrapulmonary TB (n = 48). Our study results concluded poor results of smears (11% positivity, sensitivity: 17.7%, NPV: 42.7%) and better of GeneXpert (positivity: 42%, sensitivity of 67.4%, NPV: 65.5%) and culture (positivity 57%, sensitivity 91.9%, NPV 88.3%). HspX antigen by ALISA had comparable results (positivity: 49%, sensitivity: 62.9%; NPV: 54.9%). MPT 64 antigen by ALISA also had similar results (positivity: 45%, sensitivity: 58% and NPV 52, 3%). Sensitivity and specificity were higher in pulmonary TB compared to EPTB for both antigens. HspX antigen assay by ALISA and MPT 64 ALISA over existing microbiological diagnostic methods had additional of 13%.

Conclusion:
ALISA technique for mycobacterium antigens HspX and MPT 64 was rapid, low-cost test (1-3$/test) high sensitivity and specificity and comparable to currently available methods.
Trend analysis of asthma mortality and years of life lost from 2004 to 2019 in Southern Iran
Authors: Azarbakhsh Habibollah , Dehghani Seyed S. , Hassanzadeh Jafar , Janfada Maryam , Razeghi Ahmadreza , Mirahmadizadeh Alireza 
Published: August 2023

ABSTRACT

Objective:
Asthma is a globally important non-communicable disease with major public health consequences. The aim of this study was to determine the mortality rate and years of life lost (YLL) due to asthma in southern Iran.

Methods:
All deaths due to asthma in Fars province from the electronic population-based death registration system (EDRS) were obtained. Crude mortality rate, age-standardized mortality rate, YLL and YLL rate data were calculated. The JoinPoint Regression method was used to examine the trend.

Results:
During the 16-year study period (2004-2019), 1167 deaths due to asthma occurred in Fars province among which 54.7% (638 cases) were men and 29.6% (346 cases) were in the age group of 70–79 years. Crude mortality rate of asthma had decreased by 121% and 84% in males and females, respectively from 2004 to 2019. The total years of life lost due to asthma during the 16-year study period were 7697 (0.24 per 1000 people) in men, 6882 (0.22 per 1000 people) in women. According to the join point regression analysis, the 16-year trend of YLL rate due to premature mortality was decreasing: the annual percent change (APC) was -5.6% (95% CI −8.2 to −2.9, P = 0.001) for males, −4.4% (95% CI −7.3 to −1.4, P = 0.008) for females.

Conclusion:
The trend of mortality and years of life lost due to asthma has decreased significantly during the years of study, although in some age groups, especially the age group of 45–59 years which has the highest number of years of life lost, this trend has been constant and unchanged. It is necessary to conduct other studies to investigate the possible reasons for this unchanged trend in vulnerable age groups.
Right hemi diaphragmatic eventration – A rare post SARS-COV-2 infection complication
Authors: Baby Benison P. , Mittal Neeru 
Published: August 2023

ABSTRACT
Diaphragm eventration is a rare permanent abnormal elevation of diaphragmatic muscles. They are rare entities with right-sided eventration occurring rarer still. We present a case of a 69-year-old male with right-sided hemidiaphragmatic eventration and post-COVID 19 pulmonary fibrotic changes.
A case of post renal transplant PTLD of lung
Authors: Sinha Tanay , Mishra Harshita , Thomas Rosna , Karpe Sonal P. , Waghmare Siddharth , Nair Jairaj P. , Thorve Swapnil M. 
Published: August 2023

ABSTRACT
Post Transplant Lymphoproliferative Disorder (PTLD) is a heterogeneous group of Lymphoid proliferative disorders that occur in patients post Hematogenous or Solid organ transplants. They are closely associated with Ebstein-Barr Virus and can range from polyclonal lesions to frank lymphomas. PTLD is usually a rare post-transplant complication, with the incidence being higher post Lung or Heart Transplantation and less commonly seen post-renal transplantation. The incidence post renal transplantation is less than 1%, with most of the cases being limited to the Gastro-Intestinal Tract and Lymph nodes, and incidence in the lungs being extremely rare. Here we present a case report of PTLD of the lung in a post-renal transplant recipient.
A Comparison of Loupe-Assisted and Non-Loupe-Assisted Subinguinal Varicocelectomy
Authors: Okeke Chike John , Ojewola Rufus Wale , Jeje Emmanuel Ajibola , Tijani Kehinde Habeeb , Ogunjimi Moses Adebisi 
Published: August 2023

Introduction:
Varicocele is a treatable aetiology of male infertility. Magnification with surgical loupe has been associated with improved outcome and reduced morbidity than the conventional technique without magnification.

Objective:
To compare the outcomes of two techniques of subinguinal varicocelectomy, with a surgical loupe and without.

Patients and Methods:
This was a prospective randomised hospital-based study. Forty-six patients were randomised to two arms – Group A: loupe-assisted subinguinal varicocelectomy (LASV) and Group B: open subinguinal varicocelectomy without Loupe (OSV). They all had their semen and hormonal parameters compared preoperatively and at 3 and 6 months postoperatively. Post-operative complications were also assessed. P < 0.05 was considered statistically significant.

Results:
The mean age was 38.28 ± 4.55 years with a range of 27–46 years. The mean age in Group A was 37.35 ± 4.68 and 39.22 ± 4.33 years in Group B. There was an improvement in motility, sperm count and concentration in both the groups at 3 and 6 months (P < 0.05). However, there was no difference in these parameters on comparison of the two groups at 3 and 6 months (P > 0.05). Follicle-stimulating hormone decline was significant in the OSV group at 3 and 6 months, P = 0.010 and 0.021, respectively. There was no difference in other hormonal parameters both at 3 and 6 months (P > 0.05). The pregnancy rate in each arm of study was 4.3%. All complications occurred in Group B.

Conclusion:
Both techniques resulted in improvement in seminal fluid parameters. All complications occurred in the arm that had subinguinal varicocelectomy without loupe. Loupe-assisted subinguinal varicocelectomy is safe and effective.
Increased Risk of American Tegumentary Leishmaniasis in an Urban and Rural Area of Caratinga, Brazil between 2016 and 2021
Authors: Neves Rafael L. , Ker Fabrício T. O. , Dutra-Rêgo Felipe , Rugani Jeronimo M. N. , Andrade Filho José D. , Soares Rodrigo P. , Gontijo Célia M. F. 
Published: August 2023

ABSTRACT.
We used spatial analysis tools to examine the epidemiological situation and spatial distribution of American tegumentary leishmaniasis in the municipality of Caratinga between 2016 and 2021. In addition, potential sandfly vectors were captured. All information used in this study was retrieved from public health archives and confirmed in the state health services databases. All cases were analyzed using Geographic Information Systems software. In addition, sandfly collections and molecular detection of Leishmania were carried out in areas with the highest number of cases. During the analyzed period, American tegumentary leishmaniasis (ATL) cases increased and remained high in the last years. The hotspots included urban areas of Caratinga city and the districts of Patrocínio of Caratinga and Sapucaia. The species Nyssomyia whitmani, Nyssomyia intermedia, and Migonemyia migonei were the most abundant species and the ITS1-polymerase chain reaction technique detected Leishmania DNA in these species. On the basis of our analyses, the urbanization of ATL in Caratinga has taken place in recent years. Because of the increase in the number of human cases and the presence of vectors, it is recommended that health authorities focus on control measures in hotspots.
Wastewater-Based Surveillance of Antimicrobial Resistance in Niger: An Exploratory Study
Authors: Ousmane Sani , Kollo Issifi A. , Jambou Ronan , Boubacar Rakia , Arzika Ahmed M. , Maliki Ramatou , Amza Abdou , Liu Zijun , Lebas Elodie , Colby Emily , Zhong Lina , Chen Cindi , Hinterwirth Armin , Doan Thuy , Lietman Thomas M. , O’Brien Kieran S. 
Published: August 2023

ABSTRACT.
Wastewater-based surveillance is increasingly recognized as an important approach to monitoring population-level antimicrobial resistance (AMR). In this exploratory study, we examined the use of metagenomics to evaluate AMR using untreated wastewater samples routinely collected by the Niger national polio surveillance program. Forty-eight stored samples from two seasons each year over 4 years (2016–2019) in three regions were selected for inclusion in this study and processed using unbiased DNA deep sequencing. Normalized number of reads of genetic determinants for different antibiotic classes were compared over time, by season, and by location. Correlations in resistance were examined among classes. Changes in reads per million per year were demonstrated for several classes, including decreases over time in resistance determinants for phenicols (–3.3, 95% CI: –8.7 to –0.1, P = 0.029) and increases over time for aminocoumarins (3.8, 95% CI: 0.0 to 11.4, P = 0.043), fluoroquinolones (6.8, 95% CI: 0.0 to 20.5, P = 0.048), and beta-lactams (0.85, 95% CI: 0.1 to 1.7, P = 0.006). Sulfonamide resistance was higher in the post–rainy season compared with the dry season (5.2-fold change, 95% CI: 3.4 to 7.9, P < 0.001). No differences were detected when comparing other classes by season or by site for any antibiotic class. Positive correlations were identified in genetic determinants of resistance among several antibiotic classes. These results demonstrate the potential utility of leveraging existing wastewater sample collection in this setting for AMR surveillance.
A Quasi-Dimensional Two-System Burn Rate Model for Pre-Chamber-Initiated SACI Combustion
Authors: Salerno Francesco , Kulzer Andre , Bargende Michael , Grill Michael , Burkardt Patrick , Günther Marco , Pischinger Stefan 
Published: August 2023

<div class="section abstract"><div class="htmlview paragraph">State-of-the-art spark-ignition engines mainly rely on the quasi-hemispherical flame propagation combustion method. Despite significant development efforts to obtain high energy conversion efficiencies while avoiding knock phenomena, achieved indicated efficiencies remain around 35 - 40 %. Further optimizations are enabled by significant excess air dilution or increased combustion speed. However, flammability limits and decreasing flame speeds with increasing air dilution prevent substantial improvements. Pre-Chamber (PC) initiated jet ignition combustion systems improve flame stability and shift flammability limits towards higher dilution levels due to increased turbulence and a larger flame area in the early Main-Chamber (MC) combustion stages. Simultaneously, the much-increased combustion speed reduces knock tendency, allowing the implementation of an innovative combustion method: PC-initiated jet ignition coupled with Spark-Assisted Compression Ignition (SACI). The jets penetrating the MC establish a flame propagation combustion that – with appropriate boundary conditions – triggers a controlled volume reaction in the remaining charge. The resulting ultra-fast combustion process converges to the ideal thermodynamic constant-volume cycle leading to indicated efficiencies of &gt;45%. However, implementing this combustion method requires precisely adjusted boundary conditions and a suitable geometrical design (e.g., compression ratio). This paper addresses the development of a fast-running quasi-dimensional burn rate model for PC-initiated SACI combustion to conduct robust design studies and complement existing testing methodologies (3D-CFD, experimental). The modeling approach considers two thermodynamic systems (PC and MC) connected through orifices. Both systems use the two-zone entrainment model for flame propagation combustion. Furthermore, the eventual MC volume reaction is modeled by a multi-pseudo-zone approach based on a distributed auto-ignition integral. The models are integrated into the so-called cylinder module developed at the Institute of Automotive Engineering Stuttgart and validated using measurement data of two single-cylinder research engines using different fuels (E100, RON95E10), loads (<i>IMEP</i> = 6 − 15 <i>bar</i>), excess air dilutions (<i>λ</i> = 1 − 2.8) and compression ratios (12.6 – 16.4), showing a satisfactory prediction of the burn rates and pressure curves.</div></div>
An Experimental Characterization of Gasoline/Ozone/Air Mixtures in Spark Ignition Engines
Authors: Anaclerio Fabio , Saponaro Gianmarco , Mancaruso Ezio , Mazzarella Carlo , Fornarelli Francesco , Magi Vinicio , Camporeale Sergio 
Published: August 2023

<div class="section abstract"><div class="htmlview paragraph">In this work, an ozone/air/gasoline mixture has been used as an alternative strategy to achieve a stable combustion in a spark ignition (SI) single cylinder PFI research engine. The air intake manifold has been modified to include four cells to produce ozone with different concentrations. In the research engine, various operating parameters have been monitored such as the in-cylinder pressure, temperature and composition of the exhaust gases, pressure and temperature of the mixture in the intake manifold, engine power and torque and specific fuel consumption. Experimental tests have been carried out under stoichiometric mixture conditions to observe the influence of ozone addition on the combustion process. The results show an advance and an increase of the in-cylinder pressure compared to the reference test-case, where a gasoline/air mixture is used. It is worth noting that, especially under stoichiometric condition, ozone concentration induces auto-ignition and knock. Thus, the influence of ozone on lean combustion has been investigated. In particular, the combustion process at 1400 rpm under lean conditions, with an air-fuel equivalence ratio around 2, has been tested with varying ozone concentrations. The results show a sensible reduction of misfire together with a higher laminar flame speed and improved flame stability. Indeed, the ozone addition on air/gasoline mixture reduces the CCV from 5% to 1.75% and an increase of fuel conversion efficiency. Furthermore, pollutant emissions have also been analyzed. The results show that <b>NO</b><sub><b>x</b></sub> slightly increases while unburned <b>HC</b>s decrease with ozone concentration.</div></div>
An Exploration of Trauma Handling Techniques Perceived by School Psychologists to Train Preservice Teachers
Authors: Mansha Shumaila , Khanam Afifa 
Published: August 2023

A tragic incident, such as an accident, physical abuse, or a natural disaster, can cause trauma, which is an emotional reaction. It is a detrimental mental state that overwhelms a person's ability to deal with difficulties in a typical manner. There is a significant trauma prevalence among pupils. Nearly 50% of girls and 60% of males suffer various traumas up until puberty, and nearly 75% of people encounter various traumas at least once in their lives (SAMHSA, 2020). Unfortunately, due to teachers' and parents' ignorance, many cases in Pakistan go undetected. The psychological, emotional, and cognitive facets of pupils' personalities are most negatively impacted by trauma. After their parents, teachers are the second stakeholders that students spend the most time with. Teachers can provide their students sage advice on how to handle trauma. They are able to support their students cognitively, emotionally, and psychologically. Unfortunately, due to a lack of thorough discussion of this subject in the pre-service training curriculum, instructors in Pakistan lack adequate training in trauma-informed treatment. This qualitative study explores the methods that seasoned psychologists working with educational institutions use to deal with trauma. The research involved 15 skilled psychologists and was intended to improve educators' understanding of trauma identification and intervention options. The study's goal was to gather thorough information from in-depth semi-structured interviews that would help teachers recognize trauma and use trauma-handling strategies efficiently. Participants were carefully chosen using purposive sampling. Twelve thorough themes emerged as a consequence of meticulously applying thematic analysis to the interviews. These ideas are extremely valuable for teacher preparation and provide important direction for teachers. In addition, curriculum designers and policymakers can use the study's findings to improve their materials and guidelines for dealing with trauma and trauma-informed therapies. This study illuminates an essential element of students' well-being and advances current efforts to make classroom instruction more trauma-sensitive.
Percutaneous baloon pulmonary valvulopasty for transposition of great arteries with ventricular septal defect and pulmonary stenosis patients at hanoi heart hospital: seri cases report
Authors: Nguyen Quoc Hung , Nguyen Toan Thang , Hoang Van , Nguyen Cong Ha , Tran Dac Long , Tran Cong Thanh , Nguyen Sinh Hien 
Published: August 2023

Objective: To evaluate the short-term outcome of percutaneous baloon pulmonary valvuloplasty for selected transpositon of great arteries with ventricular septal defect and pulmonary stenosis patients.
Method: from May 2022 to June 2023, 4 patients with diagnosis ccTGA- VSD- PS underwent baloon pulmonary valvulopasty at Hanoi Heart Hospital. Data was obtained before treatment, during catheterization procedures and after hospital discharge at least 6 months, with follow-up based on clinical findings and doppler echocardiography data.
Results: all 4 patients underwent procedures successfully without major complications, with post-treatment result: the increasing of oxygen saturation, increase Qp/Qs, better functional condition status compare to pre-treatment, and lower the risk of polycythemia due to cyanosis. During follow-up, 1 patient was noted with progress pulmonary valve re-stenosis and decrease oxygen saturation, candidate for reintervention.
Conclusion: percutaneous baloon pulmonary valvuloplasty is an effective and safe method for treatment of selected transpositon of great arteries with ventricular septal defect and pulmonary stenosis patients, which improve the clinical and functional condition for late and contraindicated operative patients.