bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pulmonary benign metastasizing uterine leiomyoma (PBML): a case report and review of the literature
Authors: Brincat Mark R. , Lam Shang Leen Sarah , Faruqi Asma , Sideris Michail , Lau Kelvin Kar Wing , Lawrence Alexandra 
Published: August 2023

Introduction and importance:
Benign metastasizing leiomyoma (BML) is a rare disorder characterized by the presence of benign smooth muscle tumours in extrauterine sites, typically the lungs. It classically involves perimenopausal women with a history of uterine surgery. The condition follows an indolent course but may cause clinical symptoms with large or widespread lesions.

Case presentation:
The authors report the case of a 47-year-old female who presented with a 6-month history of irregular vaginal bleeding and severe hot flushes. The patient had no previous history of gynaecological surgery. Ultrasonography and subsequent MRI identified a suspicious 105×65 mm mass involving the right uterine cornu and broad ligament. Computed tomography identified bilateral lung nodules, suspicious for metastases. Histological assessment of the final uterine surgical specimen identified a benign dissecting leiomyoma involving the broad ligament and cervix. BML was diagnosed after thoracoscopic resection of a lung lesion which revealed a histologically identical tumour with entrapped normal lung alveoli.

Clinical discussion:
This case shows that there is a minority of patients without previous uterine surgery who still go on to develop pulmonary BML. In our case, a combined treatment approach was adopted, involving substitution of hormone replacement therapy to a non-hormonal alternative, thoracoscopic resection of lung lesions and interval surveillance imaging of the chest.

Conclusions:
BML is a rare condition but should be considered as a differential in women with pulmonary nodules and a history of uterine leiomyomata. Its diagnosis and subsequent counselling can be challenging; therefore cases should be treated by multidisciplinary teams in tertiary specialized centres.
A case report on agenesis of dorsal pancreas with insulin-dependent diabetes mellitus: a rare entity
Authors: Bhattarai Himal Bikram , Lamichhane Saral , Bhattarai Madhur , Subedi Prativa , Acharya Suryakiran , Singh Prabesh Bikram , Pandit Rohit , Joshi Sajeev , Subedi Ayusha , KC Manish 
Published: August 2023

Introduction:
Agenesis of the dorsal pancreas (ADP) is a clinically rare entity that occasionally presents with abdominal pain. It is also association with various disorders of glucose metabolism.

Case presentation:
A 23-year-old male presented with continuous epigastric pain for 4 h and intermittent vomiting. He has a history of experiencing recurrent abdominal pain and diarrhoea for the past 5 years. Additionally, he has been diagnosed with type 1 diabetes mellitus for 15 years. Contrast-enhanced computed tomography of the abdomen showed the absence of body and tail of the pancreas.

Discussion:
ADP is caused by unknown factors, but may be linked to genetic mutations or changes in signalling pathways related to retinoic acid and hedgehog. Symptoms can be absent, but may include abdominal pain, pancreatitis, and hyperglycaemia due to beta-cell dysfunction and insulin deficiency. Imaging modalities, such as contrast tomography or magnetic resonance cholangiopancreatography, or endoscopic retrograde cholangiopancreatography, are crucial in the diagnosis of ADP.

Conclusion:
It is important to consider ADP as a differential diagnosis in patients with glucose metabolism disorders and associated symptoms such as abdominal pain, pancreatitis, or steatorrhea. It requires the combined use of imaging modalities such as ultrasound, contrast tomography, magnetic resonance cholangiopancreatography, or endoscopic retrograde cholangiopancreatography, as ultrasound alone may not provide a complete diagnosis.
A single-center retrospective study of hospitalized COVID-19 patients: demographics, laboratory markers, neurological complications, ICU admission, and mortality
Authors: Garcia-Dominguez Maria A. , Srichawla Bahadar S. , Pacut Peter , Quast Jared , Sivakumar Shravan , Belgrad Jillian , Panda Ashwin , Carbone Sara , Sanders Delia T. , Min Eli , Hayes Nicole T. , Bose Abigail , Lee Vanessa , Kipkorir Vincent , Ghasemi Mehdi 
Published: August 2023

Background:
The coronavirus disease 2019 (COVID-19) pandemic has unveiled a wide array of clinical biomarkers, and neurological manifestations in affected patients, necessitating further exploration.

Methods:
This single-center retrospective study evaluated clinical and neurological sequelae, demographics, as well as laboratory markers, in hospitalized COVID-19 patients from January to September 2020.

Results:
Among 1248 inpatients (median age: 68 years; 651 women), 387 (31%) were admitted to the ICU. Central nervous system (CNS) manifestations were present in 521 (41.74%) patients, while peripheral nervous system manifestations were observed in 84 (6.73%). COVID-19-related mortality occurred in 314 (25.16%) cases. ICU-admitted patients were predominantly male (P<0.0001), older (age≥60; P=0.037) and had more comorbidities such as diabetes (P=0.001), hyperlipidemia (P=0.043), and coronary artery disease (P=0.015). ICU patients exhibited more CNS manifestations (P=0.001), including impaired consciousness (P<0.0001) and acute cerebrovascular disease (P=0.023). Biomarkers linked to admission to the ICU included elevated white blood cell count, ferritin, lactate dehydrogenase, creatine kinase, blood urea nitrogen, creatinine, and acute phase reactants (e.g. erythrocyte sedimentation rate and C-reactive protein). ICU patients demonstrated lower lymphocyte and platelet counts compared to non-ICU patients. Those with CNS involvement in the ICU often exhibited elevated blood urea nitrogen, creatinine, and creatine kinase levels. Higher mortality from COVID-19 was observed in ICU patients (P<0.0001).

Conclusions:
Multiple serum biomarkers, comorbidities, and neurological manifestations in COVID-19 patients have been consistently documented and may be linked to increased morbidity, ICU admission, and mortality. Recognizing and addressing these clinical and laboratory markers is essential for effective COVID-19 management.
End-stage kidney disease patients with severe coronavirus disease: clinical characteristics, biological data, and mortality in nephrology unit, short communication
Authors: Ramdani Malika , Oujidi Hanae , Elmaghraoui Hicham , Abda Naima , Bentata Yassamine 
Published: August 2023

Introduction:
Patients suffering from end-stage kidney disease (ESKD) are particularly vulnerable to SARS-CoV-2 infection, and their risk of death is higher than for the general population. The objective was to determine the epidemiologic profile at admission and mortality among patients presenting EKSD with severe coronavirus disease (COVID-19).

Methods:
A retrospective study was conducted in the Nephrology unit between October 2020 and February 2022. Were included all adult patients who presented ESKD on dialysis, or not on dialysis with an estimated glomerular filtration rate less than or equal to 15 ml/min/1.73 m2 and presenting a confirmed COVID-19. Patients with ESKD who were immediately admitted to the ICU were excluded.

Results:
Sixty-five patients’ data were collected. The mean age was 58.9 ±16.7 years and 60% were males. Hypertension arterial and diabetes observed in 75% and 56.3% of cases, respectively. 52.3% were on haemodialysis, 4.6% were on peritoneal dialysis and 43.1% not were on dialysis. 94% of the patients were symptomatic of COVID-19, dominated by dyspnoea (87.5%), cough (65.6%), and fever (58.5%). More than half of patients (58.5%) showed signs of gravity and 62% required oxygen therapy. According to thoracic scan, 72.3% were classified COVID-19 Raw Data System 5 and 6. Most patients had severe anaemia (58.5%), lymphopenia (81.3%), and high levels of C-reactive protein (54%), D-Dimer (93.6%) and ferritin (91.2%). 38.5% of patients presented complications of whom 60% were transferred to ICU. Mortality was observed in 8% of cases.

Conclusion:
Rigorous monitoring is necessary for patients in ESKD, particularly those with comorbidities, to reduce the risk of severe form of COVID-19.
Bevacizumab side effects and adverse clinical complications in colorectal cancer patients: review article
Authors: Minhajat Rahmawati , Harjianti Tutik , Islam Itzar Chaidir , Winarta Sanjaya , Liyadi Yason Nikolaus , Bamatraf Nabilah Putri , Amanuddin Rabbaniyah 
Published: August 2023

Objective:
This review aimed to evaluate the effect of bevacizumab on adverse events and the quality of life (QoL) from colorectal cancer (CRC) patient.

Methods:
A literature search was conducted from PUBMED, MEDLINE databases and some valid literatures from another databases that published in the last 10 years, and the design is an observational and randomized controlled trial (RCT).

Results:
CRC is a malignancy, which happens in the colon or rectum. One of the therapy for CRC is by using bevacizumab, a monoclonal antibody. However, the usage of bevacizumab is still become a controversy because of its clinical complications. Several studies showed that bevacizumab could cause some adverse events in the cardiovascular, gastrointestinal, hematology, and others body systems and affect the CRC patient QoL. However, the clinical complication of this drug is also affected by the combination therapy regimen used.

Conclusions:
The use of bevacizumab could cause some adverse event in different aspects, including cardiovascular, gastrointestinal, hematology, and others. Some of those are significant, but others are not. Besides that, using bevacizumab as a treatment regiment could also affect the QoL of CRC patients, but it is also affected by the combination therapy regimen used.
Augmented reality-based training versus standard training in improvement of balance, mobility and fall risk: a systematic review and meta-analysis
Authors: Lamichhane Pratik , Sukralia Shreya , Alam Benish , Shaikh Shawn , Farrukh Shireen , Ali Shahid , Ojha Rajeev 
Published: August 2023

Objective:
Augmented reality (AR) technology is being used recently in healthcare, especially for rehabilitation purposes, owing to its ability for repetition, rapid feedback, and motivation for patients. This systematic review and meta-analysis aims to compare the efficacy of AR-based interventions to conventional physical interventions in improving balance, mobility, and fall risk.

Material and methods:
PubMed, Google Scholar, Scopus, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to January 2023. Randomized trials and observational cohort studies comparing the effects of AR-based exercises with conventional training in patients 18 years and older were included in the analysis. Studies using virtual reality, case reports and series, reviews, meta-analyses, letters, and editorials were excluded. Post-intervention data on the Berg Balance Scale (BBS) and Timed Up and Go (TUG) Test were extracted and studied. The fixed-effects inverse variance model was utilized to pool the extracted data.

Results:
Out of 438 articles, seven articles (199 participants) comparing AR-based exercise with the standard training were included in the systematic review. Six articles with sufficient data on the parameters were included in the meta-analysis. AR-based exercises resulted in a significantly higher BBS score than conventional exercise (Hedge’s g=0.48, 95% CI=0.19–0.77, P<0.001). The BBS value was significantly higher in AR-based training of 8 weeks or more (Hedge’s g=0.88, 95% CI=0.46–1.31) when compared with trainings conducted for less than 8 weeks (Hedge’s g=0.11, 95% CI=−0.30 to 0.52), P=0.01). Likewise, the TUG Test score was found to be to be significantly lower in ARgroup than the controls (Hedge’s g= −0.54, 95% CI=−0.85 to −0.23, P<0.01).

Conclusion:
In comparison to conventional methods, AR-based exercises had higher improvements in balance, mobility, and fall risk parameters. The use of AR technology in elderly patients can promote independence while preventing falls and associated morbidity and mortality. There is a need for a larger randomized controlled trial to provide a more accurate comparison on efficacy and safety of different modalities of training.
Ewing’s sarcoma arising from the right sided chest wall: a case report
Authors: Vaidya Satish , Karmacharya Robin Man , Khadka Saurav , Pokharel Selene , Yadav Binay , Sharma Sanjay , Kunwar Kajol , Bhatt Swechha 
Published: August 2023

Introduction and importance:
Ewing sarcoma (ES) is a malignant tumour prevalent in young adults with a reported 5-year survival ranging between 40 and 60% in most studies. Majority of the patients with ES are usually diagnosed late with significant chest wall mass, chest pain or respiratory distress.

Case presentation:
Here, the authors present a case of a 21-year-old female with a diagnosis of right sided chest wall ES treated with neoadjuvant chemotherapy followed by surgical resection of the mass.

Clinical findings and investigations:
The patient presented to the Surgical OPD with shortness of breath for 6 months associated with chest pain on the right side. Radiological investigations including chest X-ray and multi-detector row computed tomography chest was done. Additionally, diagnosis of ES was confirmed with histopathological examination of the mass obtained from fine needle aspiration cytology.

Interventions and outcome:
She was planned for safe maximal resection of tumour with chest wall reconstruction using double prolene mesh with bone cement and the defect was sutured with adjacent ribs. Good outcome was noted on postoperative period with resolution of symptoms.

Relevance and impact:
This procedure is now commonly used and is considered as an effective treatment for chest wall tumours, which was also noted in our case and the procedure is also well tolerated.
Penile amputation after neonatal circumcision: a case report
Authors: Sheikh Omar Adam , Mohamed Shukri Said , Sarac Ahmet 
Published: August 2023

Introduction and Importance:
In children, one of the most common surgical procedures worldwide is circumcision, which has strong religious implications and is frequently performed for nontherapeutic reasons. Circumcision is typically associated with old customs. Complete penile amputation is extremely uncommon, and the prognosis is little understood.

Case Presentation:
A 7-day-old male term baby was circumcised with a cauter by an unexperienced practitioner, and the patient was admitted to the department of pediatric surgery. Both the glans and the body had become discolored and necrotic. The patient was taken into the theater and given general anesthesia. The authors removed the debridement and inserted a catheter into the urethra to prevent urethral stenosis.

Discussion:
The procedure of circumcision has several medical benefits and is widely performed for religious, cultural, and medical reasons. It is generally agreed that circumcision prevents against sexually transmitted diseases, penile and cervical cancer in adults, as well as urinary tract infections in children.
Partial or complete penile amputation injuries are rare and frequently the result of psychotic self-harm. Operators must correctly conduct the circumcision in order to prevent the potential complications that can happen when the procedure is performed out by untrained hands.
The most common cause of penile amputation injuries, whether partial or total, is psychotic self-harm. Operators must carry out the procedure carefully to prevent the potential complications that can happen when circumcision is performed by untrained hands.

Conclusion:
The authors present here a case of a 7-day-old boy who had ritual circumcision with a cauter complicated by an entire penile amputation, which was treated with the insertion of a catheter to prevent the closure of the urethra. The patient reported his penis was circumcised with cautery one day later the glans and the entire penis became discolored and necrosis, unfortunately, the entire penis was lost with the overlying skin.
Tramadol poisoning and its management and complications: a scoping review
Authors: Manouchehri Aliasghar , Nekoukar Zahra , Malakian Abdollah , Zakariaei Zakaria 
Published: August 2023

Background:
Tramadol (TR) is an opioid agonist (μ-opioid receptors) that also affects the noradrenergic and serotonergic systems. TR is a synthetic analgesic substance with opioid agonist properties that has been approved for pain management by affecting the central nervous system.

Objective:
The primary objective of this scoping review was to determine the poisoning consequences of TR and its associated symptom management techniques, as well as its effect on opioid and non-opioid receptors, metabolism, and complications on various organ systems.

Discussion:
Typically, acute overdose of TR is not considered life threatening, and most fatalities are attributed to polysubstance overdose. TR can cause drowsiness, headaches, seizures, respiratory depression, low heart rate, coma, and even death. Additionally, the prolonged use of TR can lead to addiction, with withdrawal resulting in both common and atypical symptoms.

Conclusions:
Therefore, it is recommended that patients with TR poisoning receive close monitoring of their cardiovascular system, along with a comprehensive management plan for their levels of consciousness and respiratory function.
Economic Impact of Nursing Student Course Repetition
Authors: Lewis Lisa S. 
Published: August 2023

Background:
Nursing student course repetition is a common occurrence and results in consequences for students and institutions.

Purpose:
This study sought to describe the costs of course repetition for nursing students and nursing programs.

Methods:
A qualitative multiple case study approach was used to consider 4 cases, which were analyzed according to Stake's methodology.

Results:
Students who repeated courses experienced loss of anticipated income, and additional expenses associated with extending their time in school. Institutions tended to have limited economic impact, so long as attrition was prevented.

Conclusions:
Nursing programs can consider altering policies to help those who repeat, or providing proactive support to prevent students from failing and needing to repeat.
Noncollapsibility of the odds ratio unraveled
Authors: Abdulmajeed Jazeel , Kostoulas Polychronis , Shi Zumin , Doi Suhail A.R. 
Published: August 2023

Purpose of review
The concept of noncollapsibility of the odds ratio has intrigued the epidemiology community for decades. Despite often being overlooked or negatively perceived, which can lead researchers to prefer collapsible measures, this study highlights the beneficial aspects of noncollapsibility of the odds ratio.

Recent findings
This study links recent diagnostic test research with effect measures. Noncollapsibility is a useful characteristic, and its understanding can have important implications in medical research.

Summary
We demonstrate that a change in effect could be due to confounding, noncollapsibility, or a combination of both and that noncollapsibility can be a powerful tool for data analysis and interpretation when properly understood. This study aims to help researchers demystify this complex issue and offers updated recommendations.
A Prospective Randomized Clinical Study of Minimally Invasive Video-assisted Thyroidectomy for Papillary Thyroid Microcarcinoma
Authors: Ding Guoqian , Qu Xiang , Teng Changsheng , Gao Yinguang , Ge Zhicheng 
Published: August 2023

Background:
The purpose of this study was to observe the effectiveness of minimally invasive video-assisted thyroidectomy (MIVAT) in treating papillary thyroid microcarcinoma (PTMC).

Methods:
A total of 224 patients with PTMC who met the inclusion and exclusion criteria were selected from the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, between January 2017 and December 2019. They were randomized into the MIVAT group or traditional open operation group. For both groups, we observed the number of lymph node dissections, amount of intraoperative blood loss, duration of the operation, length of the incision, and number of injuries to the recurrent laryngeal nerve.

Results:
The average operation time (132.8±29.4 min) in the MIVAT group was significantly higher than that in the open surgery group (83.8±14.29 min) (P=0.026). The length of incision (2.8±0.6 cm) in patients in the MIVAT group was significantly shorter than that in patients in the open group (7.4±1.1 cm) (P=0.000). No significant differences were observed in the number of lymph node dissections (P=0.712), the amount of intraoperative bleeding (P=0.581), and the number of recurrent laryngeal nerve injuries (P=0.634). The average follow-up was 5 years, and both groups had no recurrence.

Conclusions:
In the treatment of PTMC, MIVAT had similar outcomes as traditional open operations, although the operation time was longer. However, the length of the incision was significantly shorter and thus provided cosmetic advantages for patients.
Effect of Pelvic Floor Muscle Training With Smartphone Reminders on Women in the Postpartum Period: A Randomized Controlled Trial
Authors: Chu Lei , Jin Xia , Wu Siyu , Tong Xiaowen , Li Huaifang , Chen Xinliang 
Published: August 2023

Importance
Standard postpartum pelvic floor muscle training (PFMT) can effectively reduce the incidence of pelvic floor dysfunction diseases.

Objective
This study aimed to evaluate the adherence of PFMT with smartphone application reminders on women in the postpartum period.

Study Design
We conducted a randomized controlled trial. This single-center randomized (1:1) controlled study included primiparous women admitted to Tongji Hospital between March 2022 and June 2022 (ChiCTR2200059157). Every puerpera was given pelvic floor muscle (PFM) assessment and PFMT guidance at 6 weeks after delivery. After randomization, women in the intervention group received daily training reminders from the smartphone application WeChat. Adherence to PFMT, a symptom of stress urinary incontinence, and PFM characteristics were measured 3 months later.

Results
A total of 148 participants were included in the final analysis (76 in the intervention group and 72 in the control group). The adherence rate of daily PFMT was higher in the intervention group than in the control group (53.9% vs 20.8%, P = 0.00) at 3-month follow-up. In addition, participants in the intervention group showed higher peak surface electromyography of PFMs (39.8 ± 6.2 vs 37.5 ± 5.9 μV, P = 0.03) and longer PFM endurance (8.1 ± 2.0 vs 7.3 ± 2.0 seconds, P = 0.01) than in the control group, whereas there was no difference between the 2 groups in International Consultation on Incontinence Questionnaire—Short Form (P = 0.60) and the Patient Global Impression of Improvement scores (P = 1.00).

Conclusions
Smartphone application–based PFMT could increase adherence and improves electromyography of PFMs in the short term but did not affect stress urinary incontinence symptoms in women in the postpartum period.