bluuebunny/crossref_metadata_2025_split huggingface dataset:
An observational study on the clinical picture of vernal keratoconjunctivitis at a tertiary care center in Western India
Authors: Agrawal Mohini , Dubbaka Srujana , Vats Sumedha 
Published: August 2023

Aim:
To study the clinical profile and presence of perilimbal pigmentation in cases of vernal keratoconjunctivitis (VKC).

Methods:
This was an observational, cross-sectional study conducted at a tertiary eye care center in western-Maharashtra from March 2019 to February 2020. One hundred fifty-two cases of VKC were identified by history, characteristic symptomatology, and slit-lamp examination. The Statistical Package for the Social Sciences (SPSS) version 20.0 for Windows was used. The relationship of extent of pigmentation with severity and duration of the disease was analyzed using Chi-squared test. A P value of less than 0.05 was considered significant.

Results:
Out of 152 cases, 79.61% were males. The mean age at presentation was 11.4 ± 5.62 years. A majority (38.82%) reported in the months of May–June. Most of them had mixed form followed closely by palpebral form. The most common symptom was itching. However, complications like focal-limbal stem-cell deficiency and shield-ulcer were seen in a few cases. Notably, the characteristic perilimbal-bulbar pigmentation was noted in 81 cases (53.29%; 95% CI 45.03%–61.42%; P < 0.0001), of which 15 had pigmentation in all the four quadrants (P = 0.0033). The extent of pigmentation corelated significantly with the severity of the disease (P < 0.0001). However, it did not correlate with the duration of the disease (P = 0.0794).

Conclusion:
Studies on VKC in India provide limited epidemiological data, and there has been no significant series that has explained its clinical pattern in the western part of the country. The presence of perilimbal pigmentation may be a diagnostic sign in mild VKC when signs and symptoms are subtle. This knowledge will help in early diagnosis and management and thus, help prevent sight-threatening complications of VKC.
Serum Folate Levels in Children with Epilepsy Seen in a Tertiary Health Care Facility in North Central Nigeria
Authors: Omefe PN , Adeboye MAN , Biliaminu SA , Ojuawo Ayodele 
Published: August 2023

Background:
Children suffering from epilepsy are maintained on antiepileptic drugs (AED) to ensure a reasonable quality of life. These drugs, however, are not without side effects. Notable among which is interference with the metabolism of folate with its attendant clinical implications such as megaloblastic anemia and bleeding diathesis.

Aim:
This study was carried out to determine the serum folate levels of children with epilepsy, compare the folate levels of these children with that of controls, the levels in subjects on different AED, and to investigate the possible effect of duration of AED use on serum folate levels.

Patients and Methods:
It was a comparative cross-sectional study involving children with epilepsy aged 2–14 years attending the paediatric neurology clinic of University of Ilorin Teaching Hospital (UITH), Ilorin. A total of 140 epileptic and 140 age-and-sex-matched nonepileptic children as controls were recruited into the study.

Results:
Mean serum folate levels in subjects of 6.3 ± 1.6 ng/mL was significantly lower than 7.5 ± 1.5 ng/mL in controls (P = 0.001). The mean serum folate level in subjects on AED was comparable with the value in AED naïve subjects. The mean serum folate level was also comparable among subjects on carbamazepine, phenobarbitone, and valproate as monotherapy. There was no correlation between the duration of AED use and the mean serum folate levels (r = −0.180; P = 0.069).

Conclusion:
The mean serum folate level in subjects was significantly lower than the value in controls; but was comparable in subjects on carbamazepine, phenobarbitone, and valproate as monotherapy. There was no correlation between the duration of AED use and mean serum folate levels
Timing of Laparoscopic Cholecystectomy in Acute Cholecystitis
Authors: Yuksekdag S , Bas G , Okan I , Karakelleoglu A , Alimoglu O , Akcakaya A , Sahin M 
Published: August 2023

Background:
Timing of laparoscopic cholecystectomy (LC) in acute cholecystitis (AC) is still debated.

Aims:
The aim of this study was to investigate the effect of timing on operative results; from the first appearance of symptoms to the operation.

Methods:
The study included 57 sequential patients operated laparoscopically for AC. Patients operated within the first 3 days of admission (Group 1), those operated between 4th and 7th days (Group 2) and those operated after 7th day (Group 3) were evaluated and compared with respect to demographics, time from admission to operation, duration of operation, adhesion score, complications, conversion rates, duration of hospital stay, morbidity and mortality rates, bile culture results, and histopathological evaluation.

Results:
A total of 63% of the patients were female and 21 (37%) were male. The mean age was 48 years (range, 21–74). There was no significant difference among the groups with respect to demographics (P > 0.05, for each). The duration of operation was significantly shorter in Group 1 than both Groups 2 and 3 (P < 0.05 and P < 0.001, respectively). Duration of operation was also significantly shorter in Group 2 than Group 3 (P < 0.001). Group 1 had significantly fewer adhesions compared to Group 2 and Group 3 (P < 0.05 and P < 0.001, respectively), and no significant difference was found between Group 2 and Group 3 (P > 0.05). Duration of hospital stay was significantly shorter in Group 1 compared to Group 2 and Group 3 (P < 0.001) and also was significantly shorter in Group 2 than Group 3 (P < 0.05). Group 1 had significantly lower rate of culture proliferation than Group 3 (P < 0.001), whereas no significant differences were evident in other inter-group analyses (P > 0.05, for each).

Conclusion:
LC can safely be performed within 7 days of admission in cases of AC.
Expression Level and Clinical Significance of Inflammatory Cytokines and Biochemical Markers in Gingival Crevicular Fluid During Different Crown Adhesion Patterns of Dental Implant
Authors: Wang L , Fan S , Yang J , Liu Q , Wang F , Hou X 
Published: August 2023

ABSTRACT

Objective:
The aim of this study was to investigate the expression level and clinical significance of inflammatory factors and biochemical markers in gingival crevicular fluid during different crown-binding styles in dental implant patients.

Methods:
A total of 38 patients with posterior tooth loss and implant repair were recruited and divided into two groups according to the different ways of crown bonding, including 19 prostheses (19 patients) in the adhesive retainer group and 19 prostheses (19 patients) in the modified adhesive retainer group. Moreover, the peri-implant gingival sulcus fluids of each group of patients were collected at 7, 15, 30, 60, and 90 d of post-treatment, and the expression level of each cytokine as well as biochemical marker were analyzed by enzyme-linked adsorption method, respectively.

Results:
Compared with the control group, the peri-implant plaque index and gingival bleeding index were decreased in the observation group. In addition, the secretion of peri-implant gingival crevicular fluid in the observation group was significantly higher than that of the control group. The level of IL-6, TNF-α expressions in peri-implant gingival crevicular fluid were gradually decreased with follow-up time, and the rate of decline gets slow at 15 h after operation. The TGFα in peri-implant gingival crevicular fluid in the two groups began to increase at 7 d, reached a peak at about 15 d, then slowly decreased and stabilized after 60 d. While the OCN was gradually increased during the whole detection process, slowly released before 30 d, then increasingly released and maintained at a peak state after 60 d. All the above differences were statistically significant (P < 0.05).

Conclusion:
Different crown-binding patterns of implant teeth have a significant effect on the secretion amount of peri-implant gingival crevicular fluid and the expression level of inflammatory cytokines as well as biochemical markers.
Is Idiopathic Mild Hyperprolactinemia a Cardiovascular Risk Factor?
Authors: Koca AO , Dağdeviren M , Akkan T , Keskin M , Pamuk N , Altay M 
Published: August 2023

Background:
There is a strong relationship between arterial stiffness and endothelial dysfunction and hypertension. How arterial stiffness is affected in elevated PRL conditions is uncertain. Biological action of prolactin contributing to the atherosclerotic process is a new research area.

Aims:
We aimed at investigating cardiovascular risk predictability by conducting arterial stiffness measurement in patients with idiopathic hyperprolactinemia.

Subjects and Methods:
The biochemical parameters and arterial stiffness analyses of 54 patients with idiopathic hyperprolactinemia, who had applied to our polyclinic in 2017 and 2018, and 55 healthy volunteers having similar characteristics with regard to age, sex and body mass index.

Results:
The median prolactin level of the idiopathic hyperprolactinemia patients with a median age of 31 was found to be 45 ng/mL. The peripheral and central blood pressures and pulse wave velocities (PWV) of both the patient group and the control group were found to be similar. Any relations between prolactin levels and blood pressure and arterial stiffness could not be found.

Discussion:
Our study showed that arterial stiffness did not increase in young patients with idiopathic mild hyperprolactinemia. However, the long-term effects of mildly elevated prolactin levels are unknown. Prospective randomized studies are required, that could reveal more clearly the prolactin-cardiovascular risk relation, and the clinical effects of extra-pituitary hyperprolactinemia.
Awareness of Risk Factors and Warning Signs of Stroke Among Nursing Students
Authors: Kankaya H , Yeşilbalkan Ö Usta 
Published: August 2023

ABSTRACTBackground:It is important to inform nursing students about stroke and improve their role in the clinic.Aims:We aimed to assess the awareness/knowledge of stroke risk factors and warning signs among nursing students. Therefore, we aimed to assess the awareness/knowledge of stroke risk factors and warning signs among nursing students.Materials and Methods:The descriptive and cross-sectional study was carried out between December 2017 and March 2018 with intern students at the faculty of nursing of a university. The sample consisted of 173 students. The data were collected by researchers using “Student Information Form” and “Information Form about Stroke”. The ethical and institutional permission were obtained to conduct the research.Results:Hypertension (96.5%) for risk factors, weakness (98.8%) for warning signs, blood pressure control (96.5%) for prevention measures were the most commonly identified factors. Approximately half of the students had a good level of awareness/knowledge of risk factors (53.2%) and warning signs (53.8%) for stroke. The majority of students (84.4%) had a good level of awareness/knowledge of prevention measures. Ninety-five percent of the students stated that calling an ambulance would be the first appropriate action.Conclusion:Students had a good knowledge of some of the warning signs and risk factors about stroke. Therefore, it is recommended that this subject should be emphasized more in course contents.
Demographic, Clinical, and Anthropometric Profiles and Postoperative Outcomes in Patients with Chronic Limb Threatening Ischemia
Authors: Wu Lily P. , Milambo Jean Paul , Naidoo Nadraj 
Published: August 2023

Background:
Chronic limb-threatening ischemia (CLTI) is a complex disease caused by peripheral artery disease. It is associated with ischemic foot pain (rest pain) and tissue loss in the form of chronic nonhealing foot ulcers or gangrene. CLTI has a high short-term risk of limb amputations, postoperative sepsis, and cardiovascular-related events.

Aims:
The present study was conducted to assess the demographic and anthropometric profile of patients with CLTI and their postoperative outcomes after 2-year follow-up at Groote Schuur Hospital, Cape Town, South Africa.

Methods:
This prospective descriptive pilot study, nested in a prospective cohort study, included adult patients with CLTI admitted to Groote Schuur Hospital from 1st January 2015 to 31st December 2016. Demographic data, anthropometric markers of CLTI, and the postoperative outcomes were documented using piloted and pretested vascular questionnaire. Descriptive statistics were used for baseline data, and postoperative outcomes were presented using actuarial life-table method (Kaplan–Meier analysis). Odds ratio, 95% confidence interval, and P value < 0.05 were used to test the hypothesis.

Results:
Thirty-seven (50.6%) patients had a BMI >25.0. The mean waist: hip ratio was 0.96. Prevalence of smoking was 86%. Limb salvage and ambulation at 1 year were 79% and 67%, respectively. Majority of the patients who were ambulant preoperatively remained ambulant postoperatively.

Conclusion:
Most patients had truncal obesity with a high prevalence of smoking. High postoperative ambulatory recovery among ambulant preoperative patients was a significant outcome observed in our study.
Subclinical Hypothyroidism in Children with Idiopathic Childhood Nephrotic Syndrome at a Tertiary Institution in South-West Nigeria
Authors: Solarin AU , Dada AO , Akinyosoye G , Oladimeji AB , Akinola IJ , Njokanma FO 
Published: August 2023

Background:
Hypothyroidism in children with nephrotic syndrome (NS) is often attributed to prolonged loss of thyroxine binding globulin and thyroid hormones alongside protein in the urine. It has been historically associated with steroid-resistant NS alone. However, recent evidence supports the fact that subclinical hypothyroidism (SCH) does occur even in children with steroid responsive NS. Complications such as weight gain, hypercholesterolemia, delayed growth, delayed puberty, and depression could result from hypothyroidism and be erroneously attributed to NS, or the effect of steroid used in treatment. Incidentally salt intake, the major form of dietary iodine is often restricted in children with NS, possibly exacerbating any underlying hypothyroid state.

Aim:
The study aimed to determine the burden of SCH among our cohort of NS patients.

Patients and Methods:
A comparative cross-sectional study was designed to assess SCH [defined by high TSH (>6.0 mU/L and normal free T4 (0.8–2.0 ng/dl)] in hundred children with NS aged between one and fifteen years compared with hundred age and gender matched comparison group without NS. Blood and urine samples were collected to analyze thyroid function, serum albumin, serum protein and urinary protein.

Results:
The prevalence of SCH was significantly higher in subjects with NS than their age, sex matched comparison group (12% vs. 2%, P = 0.006). The highest proportion (24.1%) of the children with NS who had SCH was found in the age range of 11–15 years and majority were females (19.4% vs. 7.8%, respectively, P = 0.086). The proportion of children with SCH were higher in those with steroid-resistant NS than those responsive to steroids (26.3% vs. 8.6% P = 0.033). The average values of serum albumin and protein were also significantly lower in children with SCH than those without (2.91 mg/dl ± 0.8 vs. 3.78 mg/dl ± 0.9 and 3.99 mg/dl ± 1.3 vs. 5.02 mg/dl ± 1.3, respectively, P < 0.005). Also, the average value of urinary protein was significantly higher in those with SCH than those without [94.29 mg/dl (42.3–101.0) vs. 69.19 mg/dL (31.2–108.2), respectively, P = 0.023]. Participants with steroid-resistant NS have almost three-folds odd of developing SCH compared to steroid sensitive subjects (AOR 2.901; 95% CI 1.831–4.012; P = 0.038).

Conclusion:
Screening of children for SCH with NS especially steroid-resistant NS and frequent relapsing steroid sensitive NS for hypothyroidism before complications arise is pertinent to their holistic management. This becomes even more imperative in our environment as iodine deficiency hypothyroidism is still prevalent in some parts of the country.
The Relationship of CRP/Albumin Ratio Level and Prognosis in Pregnant COVID-19 Patients
Authors: Yilmaz N. , Tosun F. , Comert E. , Duran M. , Tuna VD 
Published: August 2023

Background:
The C-reactive protein (CRP)/albumin ratio (CAR) is one of the new tools to assess the severity of inflammation. It is used to determine clinical severity and prognosis in many diseases.

Aim:
The present study aimed to investigate the relationship between C-reactive protein (CRP)/albumin ratio (CAR) and prognosis in pregnant patients with more severe COVID-19 infection. Retrospective study.

Patients and Methods:
The study was conducted in a retrospective manner by scanning the files of pregnant patients who had a positive polymerase chain reaction test result and were hospitalized in Adıyaman Training and Research Hospital. The patients were divided into two groups: patients who were admitted to the intensive care unit and patients who were not admitted. CRP/albumin ratio (CAR) levels were compared between these two groups. The cut-off value was determined in the prediction of intensive-care admission and poor prognosis.

Results:
117 patient files were reviewed. 13 patients were followed up with intensive care, whereas 104 patients completed their treatment in the service. The CAR levels of the patients admitted to intensive care were significantly higher (P < 0.01). In the estimation of intensive-care admission, the CAR level was determined to be 0.970 in the area under the curve with 100% sensitivity and 86.5% specificity in the receiver operating characteristic (ROC) curve. The cut-off CAR level was calculated as 1.8.

Conclusion:
CAR is a valuable biomarker for predicting prognosis, as well as follow-ups of pregnant COVID-19 patients.
Abdominal Wall Reconstruction for Desmoid Tumors Following Radical Resection from the Abdominoplasty Incision
Authors: Erdogan Osman , Parlakgumus A , Kulahci O , Irkorucu O 
Published: August 2023

ABSTRACT
Desmoid tumours are rare and locally invasive neoplasms that originate from the muscles and their aponeurosis. Incomplete excision causes recurrences; therefore, patients require aggressive resection that essentially entails tumour excision with a clear surgical margin. After radical resection, the resultant wide defect may lead to difficulty in closure of the anterior abdominal wall. Here, we report a case having surgery for large desmoid tumour of the anterior abdominal wall through an abdominoplasty incision followed by an abdominal wall reconstruction with a dual-sided composite mesh.
Investigation of Effect on Activities of Daily Living and Symptoms in Hemodilaysis Patients
Authors: Mollaoğlu M , Başer E 
Published: August 2023

ABSTRACT

Background:
Hemodialysis patients develop many physical and psychosocial symptoms associated with chronic kidney disease and its treatment. The presence of these symptoms also adversely affects an individual's activities of daily living.

Aim:
The aim of this study was to evaluate the symptoms seen in hemodilaysis patients and to examine the effect on daily living activities.

Materials and Methods:
This was a cross-sectional descriptive study carried out on 126 patients in two dialysis centers in Turkey. Patient Information Form, Dialysis Symptom Index (DSI) and Katz Activities of Daily Living Scale (KADL) were used as data collection tools.

Results:
The most frequent symptoms described by the patients undergoing hemodialysis were tiredness, sadness, and muscle-joint pain. The mean of the DSI was 30.03 (SD: 14.7). There was a statistically significant relationship between dialysis symptom index and disease duration and hemodialysis vintage (P < 0.05). In addition, the mean score of the Patients' KADL was 14.48 (SD: 2.55). Eighty-two (65.1%) patients maintain their daily living activities independently. On the other hand, 26.2% of the dialysis patients maintained their daily living activities as semi-dependent, while 8.7% were totally dependent on others. A statistically significant relationship was found between KADL, marital status, year of dialysis and presence of another chronic disease (P < 0.05). There was statistically significant relationship between DSI and KADL. In hemodilaysis patients, as the DSI score increased, the dependence on daily living activities increased.

Conclusion:
The symptoms seen in patients have a negative effect on maintaining their daily living activities. Health workers should perform symptom evaluation in patients undergoing dialysis. Thus, each patient-specific individualized care plan should be designed for effective management of these symptoms in patients. Effective symptom management will be effective in maintaining patients' daily living activities.
A Mini-National Surveillance Study of Resistance Profiles of Staphylococcus Aureus isolated from Clinical Specimens across Hospitals in Nigeria
Authors: Medugu Nubwa , Nwajiobi-Princewill Philip I. , Shettima Shuwaram A. , Mohammed Manga M. , Mohammed Yahaya , Wariso Kennedy , Akujobi Comfort N , Oduyebo Oyinlola O , Iregbu Kenneth C. 
Published: August 2023

Background:
Infections with Staphylococcus aureus cause significant morbidity and mortality worldwide. Resistant strains of S. aureus to commonly used antibiotics are being increasingly encountered in clinical practice, necessitating the need to determine the resistance pattern in Nigeria.

Methods:
Antibiotic susceptibility testing was performed on 360 S. aureus isolates from clinical specimen from seven hospitals across the six geo-political regions of Nigeria using Kirby Bauer disc diffusion technique, and E-test for vancomycin. Cefoxitin 30 μg disc was used to determine methicillin resistance, and D-test for inducible clindamycin resistance.

Results:
Methicillin-resistant S. aureus was confirmed in 176 (48.9%) of the isolates, 346 (96%) for penicillin G and 311 (86.4%) for trimethoprim. 175 (99.4%) of the 176 resistant to methicillin were susceptible to vancomycin. Linezolid, tigecycline, chloramphenicol and clindamycin had susceptibilities of 341 (94.7%), 332 (92.2%), 298 (82.8%) and 290 (80.6%) respectively. Inducible clindamycin resistance was elucidated in 25 (29.1%) of the 86 isolates. Generally, MRSA isolates were more resistant than methicillin-sensitive S. aureus (MSSA) to all antibiotics tested.

Conclusion:

Staphylococcus aureus rates of resistance are high and call for urgent action such as antibiotic stewardship programmes and periodic surveillance to enhance clinical outcomes. While targeted therapy is preferred, options for empiric treatment include chloramphenicol, clindamycin, linezolid or vancomycin.