bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Sleep and Disability Associated with Headache
Authors: Singh Angad Harshbir , Bathla Manish , Gupta Parul , Bhusri Leezu 
Published: April 2023

Background:
One of the commonest and most frequently said, quoted and understood by even the least educated elements of our society is the neurological symptom of headache. The commonly diagnosed and studied headaches are Migraine and Tension type headache [TTH]. Headache has the power to reduce the very essence of a peaceful life and produce a disability in a person.

Aims and Objectives:
The aim of our study is to approach the subject with view of correlation of quality of sleep with the disability associated with migraine and compare it to TTH.

Materials and Methods:
For the same a cross-sectional study design was adopted and a consecutive sampling procedure was adopted. The sample was subjected to basic socio-demography, VAS, PSQI and HDI. Statistical analysis was done on the collected data.

Results:
Based on scales the results were evaluated using appropriate statistical methods. It was observed that there was a higher female preponderance in both migraine and TTH, there was severe disability associated and both headaches cause poor sleep quality.

Conclusion:
The current study concludes that headache is a debilitating illness which causes significant disability to a person.
Comparison between Intermittent Epidural Bolus of Levobupivacaine 0.125% and Ropivacaine 0.2% with Fentanyl as Adjuvant for Combined Spinal Epidural Technique in Labor Analgesia
Authors: Thammaiah Srinivas Hebbal , Sreenath Rashmi Hosahalli , Swamy Akshay Hiryur Manjunatha , Kumararadhya Girish Bandigowdanahalli , Priya Sushant Satya 
Published: April 2023

Objective:
This study aims to compare levobupivacaine 0.125% and ropivacaine 0.2% with fentanyl as epidural drugs for labor analgesia using combined spinal epidural (CSE) technique regarding time for onset, duration of analgesia achieved by first epidural bolus dose and to compare the quality of labor analgesia. In addition, the study is also designed to assess the maternal and fetal outcome, incidence of instrumental delivery, degree of motor blockade, and maternal satisfaction.

Materials and Methods:
Following approval from Institutional Ethical Committee, 50 American Society of Anesthesiologists Physical Status II pregnant women requesting labor analgesia, satisfying the inclusion criteria were randomly divided equally into Groups L and R. CSE performed, 0.5 ml hyperbaric bupivacaine 0.5% with fentanyl 25 mcg administered intrathecally. IEBs 10 ml of study drugs given through epidural catheter as demand dose.

Results:
The mean onset of analgesia with Group R and group L were 16.280 ± 1.59 min and 21.480 ± 1.32 min(P = 0.000) respectively. The total duration of analgesia in Group R = 72.08 ± 1.97 min, whereas Group L = 82.160 ± 2.07 min (P = 0.000). There was no difference between the groups in terms of maternal demographic traits, mode of delivery, maternal and fetal outcome, and maternal satisfaction. Both 0.125% levobupivacaine and 0.2% ropivacaine produce excellent-quality of analgesia.

Conclusion:
Ropivacaine produces an early onset of analgesia than levobupivacaine but levobupivacaine had significantly prolonged analgesia compared to ropivacaine. Both drugs were found to be safe for labor analgesia. Maternal satisfaction and fetal outcome were similar with both the drugs.
Ethnicity Based Comprehensive Evaluation of Polymorphism in Interferon-Gamma Gene and Its Association with Pulmonary and Extra-Pulmonary Tuberculosis Risk
Authors: Priyanka  , Sharma Monika , Sharma Sadhna 
Published: April 2023

Background:
Host genetic background plays an important role in susceptibility to intracellular infectious pathogens like Mycobacterium tuberculosis (Mtb). Cellular immune response activation is vital for protection to these pathogens. Interferon-gamma (IFN-γ) plays a crucial role in this activation and preventing the intracellular growth of Mtb. A mutation in the IFN-γ gene, therefore, may lead to increased susceptibility to tuberculosis (TB) that may vary in different ethnic groups and its consequence also varies in pulmonary and extra-pulmonary TB (EPTB). Several IFN-γ gene polymorphisms are investigated for susceptibility to TB, but their associations are not always consistent as its impact may vary from one ethnicity to the other as well as with the type of TB. Hence, we performed a meta-analysis to overcome this problem. The present study involves comprehensive meta-analysis of + 874T/A polymorphism in the IFN-γ gene based on type of TB within five different ethnic groups to show its association with increased susceptibility to TB.

Methods:
Using PubMed and Google Scholar databases, a total of 50 case-control studies were retrieved having 8152 cases and 9755 controls in this meta-analysis. Thirty-eight studies of + 874T/A polymorphism of IFN-γ gene were correlated for Pooled odds ratios with 95% confidence intervals. The polymorphism was analyzed for six genetic models for five major ethnic groups accounting for heterogeneity among studies. Moreover, the sub-group analysis was based on the type of TB within each ethnic group. Trial sequential analysis was also performed for all the sub-groups to estimate the statistical consistency.

Results:
IFN-γ +874 T/A polymorphism analysis clearly confirmed the increased association of + 874AA genotype with increased TB risk. This polymorphism also showed significant association in East Asian, European, American, and African ethnic groups whereas no such association was found in Asians. Patients with pulmonary TB (PTB) confirmed the association in East Asians, Africans, and Americans, whereas patients with EPTB showed association in Asian and East Asian populations only.

Conclusions:
This study reaffirms the association of IFN-γ+874 T/A polymorphism with TB risk. It specifically confirms that IFN-γ+874 T/A polymorphism increases the susceptibility of pulmonary infection in Africans and Americans, while the East Asian population is more susceptible to both, pulmonary and EPTB.
Safety and Efficacy of High-Dose Rifampicin in the Management of Tuberculosis Meningitis
Authors: Charlie Loveness , Abay Solomon Mequante , Tesfaye Abraham , Mlera Ronald Nachipo , Mwango Samuel , Goretti Mary 
Published: April 2023

Background:

Mycobacterium tuberculosis (TB) practically affects any part of the body, but when the brain is involved, the consequences are devastating. Tuberculous meningitis (TBM) is the most severe form of drug-susceptible TB, with an estimation of more than 100,000 new cases occurring every year and a high mortality rate globally. The treatment strategy is based on pulmonary TB (PTB) management regimens which consider rifampicin as the backbone. Optimal treatment regimens for PTB may not be the most effective option for TBM due to difference in TB drug penetration across the blood–cerebrospinal fluid barrier, hence the need for other treatment options. This study aims to review the efficacy and safety of higher doses of rifampicin (>10 mg/kg) compared to 10 mg/kg rifampicin as part of standard therapy for the treatment of TBM.

Methods:
A systematic review and meta-analysis was conducted to assess the efficacy and safety of high-dose rifampicin for TBM. A search was done on PubMed, Google Scholar, and Cochrane library databases without publication date limit to identify studies providing data on the use of high-dose rifampicin for the treatment of TBM. Titles and abstracts were screened for relevance by three reviewers. Two reviewers used a predefined checklist on the inclusion criteria to assess full text for their eligibility in the review. A heterogeneity test was conducted to assess the variations among study outcomes. The risk ratio (RR) with a 95% confidence interval (CI) was calculated as a measure of intervention effect. The study is registered on PROSPERO and the registration number is CRD42020212737.

Results:
Five Phase 2 trials with a total of 1028 participants were included in this meta-analysis. All the five trials were used to analyze safety data, which found that there was no significant increase in the risk of Grade 3–5 adverse events in high-dose rifampicin (RR = 1.05; 95% CI = 0.95–1.18). Only four of them were included for the analysis of efficacy. The findings indicated that exposure to high-dose rifampicin is not associated with a reduced risk of mortality (RR = 0.95; 95% CI = 0.78–1.16).

Conclusions:
It can be concluded from this meta-analysis that there is no significant relation of high-dose rifampicin with adverse events and the reduction of mortality in TBM patients. Whether in future optimized TBM treatment regimen will include high-dose rifampicin or not should be determined by a large-scale clinical trial.
A Diffused Community Tuberculosis Outbreak That Could Be Detected Earlier Using Surveillance Data, Japan, 2012–2014
Authors: Ota Masaki , Uchimura Kazuhiro , Hirao Susumu 
Published: April 2023

Background:
Early detection of an outbreak is a role of disease surveillance systems; however, tuberculosis (TB) surveillance systems were underutilized to detect the outbreaks. In mid-2015, a local health office of central Japan noticed the number of TB cases of city in 2012–2014 were well above the expected numbers. This study was conducted to determine whether and when a community TB outbreak could be detected and characterize the cases using the national surveillance data.

Method:
The surveillance data of the A city and surrounding areas were retrospectively reviewed and analyzed for 2006–2018.

Results:
The TB notification rates of the A city from 2012 to 2014 were 28.0 (95% confidence interval [CI]: 20.3–38.4), 26.0 (95%CI: 18.6–36.0), 28.2 (95%CI: 20.3–38.4) per 100,000 population, respectively, higher than that of the entire prefecture (13.6, 13.0, 13.3, respectively). Similarly, in the neighboring B city, the rates of 2012 and 2014 were 51.0 (95%CI: 27.2–87.2) and 51.2 (95%CI: 27.3–87.5), respectively, higher than that of its parent prefecture (13.4 and 12.7, respectively). By the end of July 2012 (A city) or August 2012 (B city), the accumulated numbers of TB cases exceeded the previous annual TB cases. The average TB notification rates of A and B cities for 2012–2014 were higher than the surrounding areas.

Conclusion:
A community TB outbreak without well-defined setting could be detected by monitoring TB surveillance data.
The Biofilm Formation of Nontuberculous Mycobacteria and Its Inhibition by Essential Oils
Authors: Polyudova Tatyana V. , Eroshenko Daria V. , Pimenova Elena V. 
Published: April 2023

Background:
Nontuberculous mycobacteria (NTM) form two types of biofilms: Bottom biofilm and pellicle. The spatial distribution of cells between these types of biofilms and their dispersion into the liquid medium depends on the ratio of the nutrient components of the growth medium. The inhibition of biofilm formation by NTM can be achieved through the use of lipophilic compounds, such as essential oils (EOs).

Method:
The biofilm and pellicle formation of Mycobacterium smegmatis and Mycobacterium avium on four nutrient media under static conditions and in the vapors of six EOs was evaluated by conventional method. The antimycobacterial effect of EOs was also studied by the disc diffusion method.

Results:
The bottom biofilm and pellicle formation of NTM largely depended on the composition and availability of nutrients. Nutrient media in which NTM form powerful bottom biofilm or pellicle or both have been determined. The growth of studied NTM strains on agar was highly sensitive to the EOs of Scots pine, Atlas cedar, bergamot, and a mixture of EO of different plants. The cultivation of bacteria in the EO vapors also resulted in total suppression of the pellicle for all studied NTM strains.

Conclusions:
Our data clearly indicate that the carbon-nitrogen ratio is involved in the regulation of the spatial distribution of the biofilm. The preventing effect of EOs vapors, especially the synergistic action of mixture of EOs on the biofilm and pellicle formation by NTMs can be observed.
Clinical Profile, Diagnosis, Treatment, and Outcome of Patients with Tubercular versus Nontubercular Causes of Spine Involvement
Authors: Gupta Nitin , Bhat Shyamasunder N. , Reddysetti Suhas , Afees Ahamed M. A. , Jose Divya , Sarvepalli Aravind Srivatsa , Joylin Sowmya , Godkhindi Vishwapriya M. , Rabaan Ali A. , Saravu Kavitha 
Published: April 2023

Background:
In tuberculosis (TB) endemic areas, other pyogenic causes of spine involvement may be missed. The study aimed to describe TB and non-TB causes of spine involvement and identify features that can help in differentiating them.

Methods:
A retrospective cohort study was conducted to screen the clinical records of all admitted patients (Kasturba Hospital, Manipal) in 2018–20 for a diagnosis of spondylitis and/or sacroiliitis. The clinical features, radiological findings, laboratory parameters, treatment details, and outcomes were compared among those diagnosed with confirmed TB, confirmed brucellosis, or confirmed pyogenic infection. A scoring system was also developed to differentiate spondylodiscitis due to tuberculous and pyogenic causes. The qualitative variables were compared using the Chi-square test, while quantitative variables were compared using the one-way analysis of variance test.

Results:
Of 120 patients with spine infections, a total of 85 patients were confirmed with the microbiological diagnosis of interest. Involvement of the thoracic spine, longer duration of illness, and caseous granulomatous reaction on histopathology was more common in TB patients. Male gender, involvement of lumbar vertebra, and neutrophilic infiltrate on histopathology were more common in brucellosis patients. Male gender, diabetes mellitus, involvement of lumbar vertebra, neutrophilic infiltrate on histopathology, leukocytosis, and increased C-reactive protein were more commonly seen in patients with pyogenic infection. The scoring system had a sensitivity and specificity of 75% and 91%, respectively, when used to differentiate TB from pyogenic infection.

Conclusions:
In resource-limited settings, suggestive findings can be used to decide empiric therapy.
Turnaround Times of the Sputum Sample Courier System at Tuberculosis Treatment Centers in Lusaka, Zambia, 2021
Authors: Daka Samuel , Matsuoka Yuko , Ota Masaki , Hirao Susumu , Phiri Abraham 
Published: April 2023

Background:
Health facilities which do not have capacity to diagnose tuberculosis (TB) depend on other facilities. This involves the courier of specimen such as sputum to diagnostic centers. This study was aimed at determining the turnaround time of sputum examinations for TB patients involving a courier system between the treatment and diagnostic centers.

Methods:
The study tracked the sputum samples between TB treatment and diagnostic centers. Sputum samples for both diagnosis and follow-up reasons were purposely and serially tracked from the time they were sent to the laboratory to the time results were received at the treatment centers.

Results:
Of the 65 sputum samples tracked at Chazanga, results were available for 49 (75.4%), 6 (9.2%) were unaccounted for, 4 (6.2%) were rejected by the laboratory, 4 (6.2%) had “error” results, and 2 (3.1%) were declared “missing” because it took more than a month to return the results. The turnaround time ranged from 2 days to 18 days with an average of 5.8 days (95% confidence interval [CI]: 4.5–7.1 days). At Kaunda Square, of the 49 samples tracked, results were available for 44 (89.8%), 2 (4.1%) were unaccounted for, 2 (4.1%) were rejected, and 1 (2.0%) was declared “missing.” The turnaround time ranged from 2 to 25 days with an average of 6.3 days (95% CI: 5.3–7.4 days).

Conclusion:
The turnaround times of sputum examinations of the two treatment centers were long. The courier system should be closely monitored to determine if it is performing well because the system is still necessary for facilities without laboratories.
Programmatic Challenges in Managing Multidrug-Resistant Tuberculosis in Malawi
Authors: Charlie Loveness , Saidi Bibie , Getachew Emnet , Wanjiru Cathreen Lydiah , Abebe Mekdelawit , Tesfahunei Hanna Amanuel , Atim Mary Gorret , Manyazewal Tsegahun , Mlera Ronald Nachipo 
Published: April 2023

Background:
Multidrug-resistant tuberculosis (MDR-TB) is one of the most urgent challenges that Malawi tends to take a firm public health action. A recent increase in multidrug MDR-TB cases, a decrease in treatment success rate, and a double increase of lost-to-follow-up call into question the country's programmatic management of MDR-TB (PMDT). As such, the study aimed at exploring programmatic challenges in managing MDR-TB in Malawi.

Methods:
A comprehensive and nonsystematic search was made in PubMed and Google Scholar using mainly the keywords “MDR-TB” “extensively drug-resistant TB,” Malawi. The study reviewed existing guidelines and gray literature and reviewed data obtained from the national TB program (NTP) as well.

Results:
The study found the following challenges affecting PMDT: decrease in funding, partial access to GeneXpert, delay in diagnosis, long treatment duration, lack of adequate personal protective equipment, the long turnaround time of culture results, failure to initiate all diagnosed patients on treatment, absence of alternative second-line medicines, and lack of transport from health facilities to patient homes.

Conclusion:
If the Malawi NTP is to achieve a vision of a “TB-free Malawi,” rigorous efforts at all levels must be made, including mobilizing domestic resources for improved MDR-TB program performance. Developing partners should continue providing the much-needed funding to the Malawi government to stand in the wake of the MDR-TB crisis.
A Systematic Review of Adrenal Insufficiency among Patients with Pulmonary Tuberculosis in Sub-Saharan Africa
Authors: Azeez Taoreed Adegoke , Irojah Olakunle Ayorinde , Lakoh Sulaiman , Lawal Abimbola Olukayode , Ajiboso Olabiyi Abiola 
Published: April 2023

Introduction:
Tuberculosis (TB) is a disease of public health importance globally. The incidence of pulmonary TB is rising in sub-Saharan Africa. Bilateral adrenal destruction and the use of medications such as rifampicin are possible mechanisms by which TB cause adrenal insufficiency. Failure to promptly recognize adrenal insufficiency may lead to a medical crisis causing death. This systematic review aimed to identify the frequency of adrenal insufficiency, the clinical presentation and its predictors in patients with pulmonary TB in sub-Saharan Africa.

Methods:
The study was a systematic review. Medical databases and the grey literature were searched. Literature search and studies selection were done following the PRISMA guidelines.

Results:
The total sample size was 809. The frequency of adrenal insufficiency among patients with pulmonary TB in sub-Saharan Africa was 0.9%–59.8%. Patients with adrenal insufficiency had symptoms such as nausea, vomiting, darkening of the skin, salt craving, and weight loss. Other symptoms were dry, itchy skin, abdominal pain, and muscle pain. The predictors of adrenal insufficiency among patients with pulmonary TB in sub-Saharan Africa were low blood pressure, low blood glucose, presence of multidrug-resistant TB, and low CD4 count. Other predictors were abdominal pain and generalized skin hyperpigmentation.

Conclusion:
The frequency of adrenal insufficiency in patients with pulmonary TB can be as high as 50%. The presence of low blood pressure, low blood glucose, multidrug-resistant TB, and generalized skin hyperpigmentation is a pointer to the possibility of adrenal insufficiency in these patients.
Two-Dimensional Strain Echocardiographic Parameters and Clinical Outcomes Associated with Significant Atrioventricular Regurgitation in a Single-Center Adult Fontan Population
Authors: Chen Tse Ben , Sathananthan Gnalini , Janzen Mikyla , Grewal Jasmine 
Published: April 2023

Background:
Significant atrioventricular valve regurgitation (AVVR) is prevalent in Fontan adults. Two-dimensional speckle-tracking echocardiography allows for evaluation of subclinical myocardial dysfunction and offers technical benefits. We aimed to evaluate the association of AVVR with echocardiographic parameters and adverse outcomes.

Materials and Methods:
Fontan adults (≥18 years) with lateral tunnel or extracardiac connection actively followed at our institution were retrospectively reviewed. Patients with AVVR on most recent transthoracic echocardiogram (≥grade 2 as per American Society of Echocardiography guidelines) were matched with Fontan controls. Echocardiographic parameters, including global longitudinal strain (GLS), were measured. The composite outcome of Fontan failure included Fontan conversion, protein losing enteropathy, plastic bronchitis, and New York Heart Association Class III/IV.

Results:
Sixteen patients (14%, mean age 28.4 ± 7.0 years) with predominantly moderate AVVR (81%) were identified. The mean duration of AVVR was 8.1 ± 5.8 months. There was no significant reduction in ejection fraction (EF) (51.2% ± 11.7% vs. 54.7% ± 10.9%, P = 0.39) or GLS (−16.0% ± 5.2% vs. −16.0% ± 3.5%, P = 0.98) associated with AVVR. Larger atrial volumes and longer deceleration time (DT) were observed in the AVVR group. Patients with AVVR and a worse GLS (≥−16%) had higher E velocity, DT, and medial E/E’ ratio. The incidence of Fontan failure did not differ from controls (38% vs. 25%, P = 0.45). Patients with worse GLS (≥−16%) demonstrated a marked trend toward a higher incidence of Fontan failure (67% vs. 20%, P = 0.09).

Conclusions:
In Fontan adults, a short duration of AVVR did not influence EF or GLS but was associated with larger atrial volumes and those with worse GLS demonstrated some differences in diastolic parameters. Larger multicenter studies throughout its disease course are warranted.
Sostenibilidad femenina y startups: análisis de la comunicación del liderazgo de mujeres emprendedoras en España y Portugal
Authors: Torres-Mancera Rocio , Martínez-Rodrigo Estrella , Amaral Santos Claudia 
Published: April 2023

Introducción: la innovación para emprender modelos de negocios responsables y sostenibles es la máxima actual en la lista de prioridades de la Unión Europea, en consonancia con los Objetivos de Desarrollo Sostenible marcados por las Naciones Unidas en su Agenda internacional para el 2030. La creación y desarrollo de proyectos y empresas conscientes de su impacto en el planeta a corto, medio y largo plazo generan mucho más valor cuando este liderazgo proviene de una vocación empresarial femenina, al optimizar el valor de la diversidad en la gestión de los recursos, tradicionalmente dirigidos por el ecosistema masculino. Metodología: se aplica una triangulación metodológica con entrevistas en profundidad a informantes clave internacionales, análisis de contenidos digitales en las regiones de Andalucía (España) y Aveiro (Portugal) y la revisión de literatura científica previa. Resultados: las nuevas startups hispano lusas siguen siendo lideradas mayoritariamente por hombres, mientras que la cuota de liderazgo emprendedor femenino abarca en torno a un 26,5% del total de la muestra. Discusión: aunque exista un amplio rango de mejora en presencia y comunicación, las mujeres están incrementando su actividad emprendedora e innovadora. En todo caso, la co-responsabilidad con la comunidad y el cuidado del legado medioambiental son valores de diferenciación profesional aún latentes. Conclusiones: la investigación pone de manifiesto datos objetivos actuales internacionales referentes a la comunicación digital corporativa, que permiten ofrecer una visión completa sobre la realidad de las mujeres que están apostando por modelos de negocios cuya misión, visión y valores se centran en la sostenibilidad.