bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age-sex effect on in-hospital complications and mortality in patients with Takotsubo syndrome. Insights from the National Inpatient Sample
Authors: Vriz Olga , Alzahrani Talal , Landi Irene , Mushtaq Ali Hassan , Shaik Abdullah , Elshaer Ahmed Nahid 
Published: April 2023

Age and sex differences in Takotsubo syndrome (TTS) are still a matter of debate. The aim of the present study was to evaluate the difference in cardiovascular (CV) risk factors, CV disease, in-hospital complications, and death within different sex-age groups. Using the National Inpatient Sample database between 2012 and 2016, 32,474 patients older than 18 years of age hospitalized with the primary diagnosis of TTS were identified. A total of 32.474 patients were enrolled, 27,611 (85.04%) were females. Cardiovascular risk factors were higher in females while CV diseases and in-hospital complications were significantly higher in males. The mortality in males was twice as high as that of female patients (9.83% vs 4.58%, p<0.01) and in logistic regression model after adjustment for confounders, odds ratio was 1.79, CI 1.60-2.02, p<0.01. After dividing the group based on age, in-hospital complications were inversely related to age in both sexes, and the length of in-hospital stay was double in the youngest group compared to the oldest one. Mortality increased progressively with age in both groups but was constantly higher in males for each age group. A multiple logistic regression analysis for mortality was performed for the two sexes separately and the 3 age groups considering the youngest one as the reference group. In females, the OR was 1.59 and 2.88 respectively for group 2 and 3, for males OR was 1.92 and 3.15, all of them statistically significant (p<0.01). In-hospital complications were more common in younger patients with TTS and particularly in males. Mortality was positively correlated with age for both sexes, but mortality was higher in males compared to females in all age groups.
Response to insecticides and underlying mechanisms of resistance in the field populations of Aedes aegypti Linnaeus (Diptera: Culicidae) in Puducherry, India
Authors: Nihad P P Muhammad , Subramanian Muthukumaravel , Gunasekaran K , Kumar Ashwani 
Published: April 2023

Background & objectives:
Mosquito-borne diseases are major threats to human health worldwide. Successful control of vector mosquitoes requires periodic updates on their response to the insecticides that are in use. Different classes of neurotoxic insecticides have been used in vector control programs. Ae. aegypti and Ae. albopictus are the primary vectors of dengue and have developed resistance to organophosphates and synthetic pyrethroids that are used in vector control programs. Monitoring insecticide pressure and studying the underlying mechanisms of resistance in the field populations of Aedes aegypti are important to formulate resistant management strategies for their control programs.

Methods:

Aedes aegypti were collected from study sites Lawspet and Abishegapakkam and F1 progeny was subject to biochemical assays to determine the enzyme activity. Insecticide susceptibility tests were conducted to determine vector susceptibility/resistance to malathion and deltamethrin. Adult dried mosquitoes were subjected to multiplex PCR to detect point mutation in the VGSC gene.

Results:
Insecticide susceptibility test results revealed that Aedes aegypti is resistant to malathion and incipient resistance to deltamethrin has emerged. It was observed that β-esterase and monoxygense activity were significantly higher in Lawspet sample than the laboratory strain, whereas it was comparatively lower in Abishegapakkam sample than laboratory strain. Multiplex PCR assays showed no kdr mutation in all Ae. aegypti strains.

Interpretation & conclusion:
Monitoring insecticide resistance in Ae. aegypti would help the local health authorities to implement a rationalized approach for insecticide use in vector control.
The Effect of Dentin Matrix Proteins on Differentiation of Autologous Guinea Pig Dental Pulp Stem Cells
Authors: Taher Abolfazl Salehi , Sadrabad Maryam Jalili , Izadi Armin , Ghorbani Raheb , Sohanian Shabnam , Saberian Elham 
Published: April 2023

Backround:
In this study, we aimed to investigate the effect of dentin matrix proteins on the differentiation of guinea pig dental pulp stem cells to regenerate Dentin Bridge.

Materials and Methods:
This experimental study was performed on six adult male guinea pigs. Pig incisor teeth were divided into two groups: the first group was induced by calcium hydroxide as a control group and the second group was induced by matrix protein induction as a case group. After 1 and 3 days, the samples of both groups were stained by hematoxylin and eosin to examine the presence of odontoblast-like cells, the severity of inflammation, and the type and amount of dentin which was made, microscopically and for counting stem cells in the dentin site. Immunohistochemistry staining method was done.

Results:
In the case group, the amount of reconstituted dentin, the presence of stem cells and odontoblastic differentiation were higher than in the control group (P < 0.05) and the type of regenerated dentin potentially was of higher quality, although it was not statistically significant (P = 0.924). However, the amount of regenerated dentin (P = 0.001), the presence of pulp stem cells (P = 0.001) and the increased quality of regenerated dentin (P = 0.001) in both groups on the 1st and 3rd days were significantly different.

Conclusion:
The results showed that dentin matrix proteins were more effective on stem cell migration, odontoblastic differentiation, amount and quality of restorative dentin than the control group, but did not significantly; probably because low sample size.
Evaluation of some immune and inflammatory responses in diabetes and HIV co-morbidity
Authors: Chinyelu Chukwuanukwu Rebecca , Bernice Nwosu Ngozi , Ositadinma Ifeanyichukwu Martin , Chinyere Nsonwu-Anyanwu Augusta , Onochie Manafa Patrick 
Published: April 2023

Background: Co-existence of diabetes in the HIV infected reportedly further complicates the attendant impairment of immunity and increases susceptibility to opportunistic infections.
Objective: This study aimed to evaluate some immune and inflammatory parameters in HIV and type 2 diabetes (T2D) co-morbidity: Immunoglobulin M and G (IgM and IgG), Interleukin-6, CD4+ T-cells and C-reactive protein.
Method: The study involved 200 subjects grouped according to their HIV and diabetes status: Group 1 ‘Diabetic HIV seropositive’( n=40), Group 2 ‘Non diabetic HIV seropositive’(n=60), Group 3 ‘Diabetic HIV seronegative’(n=50), and Group 4 ‘Control non diabetic HIV seronegative’(n=50). Blood samples were collected for testing.
Results: CRP levels were significantly elevated in diabetes and HIV co-morbidity compared to other groups. IL–6 levels were significantly higher in diabetics with or without HIV infection. In addition, IL-6 was significantly elevated in individuals with poor glycemic control (HbA1c > 9.0%) compared to those with good glycemic control. IgG and IgM levels in diabetic HIV seropositive subjects were highest compared with other groups.
Conclusion: The increased IL-6, CRP, IgG, IgM and decreased CD4+ T cell counts observed in co-morbidity suggest that HIV and T2D co-morbidity exacerbate the immune and inflammatory impairment observed in either disease entity.
KeyWords: Diabetes; HIV; co-morbidity; immune responses; inflammation; glycemic control.
Hypertension in people living with HIV on combined antiretroviral therapy in rural Tanzania
Authors: Trifirò Silvia , Cavallin Francesco , Mangi Sabina , Mhaluka Lawrence , Maffoni Silvia , Taddei Stefano , Putoto Giovanni , F Torelli Giovanni 
Published: April 2023

Exposure to anti-retroviral therapy in HIV infection has been associated with hypertension, but whether and to what extent HIV-related factors and anti-retroviral treatment contribute to hypertension is not well defined; in addition, data are particularly scarce in Sub-Saharan Africa.
Aim of the study was to investigate prevalence and awareness of hypertension in a cohort of people living with HIV (PLWHIV) on anti-retroviral therapy in rural Tanzania, and to identify possible predictors of hypertension.A cross-sectional study on hypertension in PLWHIV was conducted at Tosamaganga District Hospital, Iringa Region, Tanzania. Subjects on anti-retroviral therapy, age 26-80 years and with monthly attendance to the HIV clinic, were considered eligible. A total number of 242 patients were included in the analysis. Sixty-two subjects (26%) had hypertension, the majority (77%) of them not aware of the condition and/or not on treatment. Older age, higher BMI and lower baseline T-CD4 count were predictors of hypertension at multivariate analysis. The results of the study suggest that hypertension screening should becomepart of ordinary care of PLWHIV in Tanzania, particularly in subjects with more severe immunosuppression. Leveraging already existing HIV services could be an option to prevent the burden of non-AIDS complication and related deaths.
Keywords: HIV; Hypertension; sub-Saharan Africa.
Cost-effectiveness of dolutegravir vs. efavirenz-based combined antiretroviral therapies in HIV-infected treatment-naive patients in a Nigerian treatment centre
Authors: Isah Abdulmuminu , O Chukwu Patrick , Abba Abubakar , U Igboeli Nneka , Ebere Ayogu , F Omotola Olusegun , A Alozie Faith , I Ekwunife Obinna , O Adibe Maxwell 
Published: April 2023

Background: Dolutegravir (DTG) based antiretroviral therapy (ART) has largely replaced Efavirenz (EFV) based therapy as the preferred first-line regimen in the treatment of adults with HIV. This study was carried out to evaluate the comparative cost-effectiveness of DTG and EFV-based ART in HIV-infected treatment-naïve patients in a treatment centre in Nigeria.
Methods: This was a retrospective case-control study of patients initiated on DTG vs. EFV-based regimens from January 2018 to December 2019 at the APIN/HAVARD clinic of Nigeria’s Jos University Teaching Hospital. The current viral load result was used to determine treatment effectiveness using a benchmark of ≤200 copies/mL. Sensitivity analysis was carried out to ensure the robustness of the benchmark. The total cost of treatment was obtained by summing up the relevant cost components. Appropriate descriptive and inferential statistics were employed in data analysis using Statistical Product and Services Solutions (SPSS) V.25. The incremental cost-effectiveness ratio of DTG compared to EFV was presented as cost/effectiveness.
Results: Treatment was effective in 42(51.9%) and 58(71.6%) patients initiated on DTG and EFV-based regimen, respectively. The incremental cost-effective ratio (ICER) of patients on DTG compared to those on EFV was $10.5076 per effectiveness, which was less than 1% of the Nigerian 2019 per capita Gross Domestic Product. Sensitivity analysis showed the robustness of the result.
Conclusion: Efavirenz based regimen had higher treatment effectiveness than DTG-based regimen in treatment-naive patients after initiating treatment in a short term. Compared to EFV, DTG-based regimen is cost-effective in the management of treatment naïve HIV patients.
Keywords: Average cost-effectiveness ratio; cost-effectiveness; Dolutegravir.
Effect of nutrition education on dietary diversity among HIV Patients in Southeast, Nigeria
Authors: Lilian Ezenwosu Ifeyinwa , Uchenna Ezenwosu Osita 
Published: April 2023

Background: Integrating nutrition interventions which include nutrition education in HIV/AIDS care program may help people living with HIV/AIDS (PLWHA) make better decisions regarding their nutrition to improve their immune system.
Objective: To determine the effect of nutrition education on dietary diversity among HIV/AIDS patients in Southeast, Nigeria.
Methods: A quasi-experimental study was conducted among 370 HIV patients divided into two groups of 185 each for the study and control groups. The nutrition education program was delivered to the study group. In both groups, their practice of dietary diversity was ascertained pre- and post-intervention. The Chi-square test and McNemar were used in the analysis.
Results: Practice of dietary diversity was low among 79(42.7) and 69(37.3) respondents in the study and control groups respectively (x2 =1.126, p=0.289). Three months after the intervention, the proportion of respondents with low dietary diversity significantly decreased from 42.7% to 22.7% in the study group while the control group had no appreciable reduction (x2=7.532, p=0.006).
Conclusion: Nutrition education plays a positive role in the dietary diversity of PLWHA. This suggests that nutrition education should be a key component in the care of PLWHA for a better nutritional outcome.
Keywords: Nutrition education; dietary diversity; HIV/AIDS.
Staging of COVID-19 disease; using selected laboratory profiles for prediction, prevention and management of severe SARS-CoV-2 infection in Africa–review
Authors: Sendagire Hakim , Kiwuwa Steven , Dhamani Ali , Akugizibwe Roselyne , Lwasa Yasin , Bukenya Andrew , Kafero Mukasa Hussein , Kakeeto Patrick , Nankinga Ziadah , Bbosa Godfrey , Babirye Juliet , Nankabirwa Harriet , Nabadda Susan 
Published: April 2023

There are many uncertainties on the future management of the coronavirus disease 19 (COVID-19) in Africa. By July 2021, Africa had lagged behind the rest of the world in Covid-19 vaccines uptake, accounting for just 1.6% of doses administered globally. During that time COVID 19 was causing an average death rate of 2.6% in Africa, surpassing the then global average of 2.2%. There were no clear therapeutic guidelines, yet inappropriate and unnecessary treatments may have led to unwanted adverse events such as worsening of hyperglycemia and precipitating of ketoacidosis in administration of steroid therapy. in order to provide evidence-based policy guidelines, we examined peer-reviewed published articles in PubMed on COVID 19, or up-to date data, we focused our search on publications from 1st May 2020 to 15th July, 2021. For each of the studies, weextracted data on pathophysiology, selected clinical chemistry and immunological tests, clinical staging and treatment. Our review reports a gross unmet need for vaccination, inadequate laboratory capacity for immunological tests and the assessment of individual immune status, clinical staging and prediction of disease severity.
We recommend selected laboratory tools in the assessment of individual immune status, prediction of disease severity and determination of the exact timing for suitable therapy, especially in individuals with co-morbidities.Keywords: COVID-19; antibodies; cytokines; clinical chemistry; biomarkers; hematology; viral load (VL) RNA copy numbers;SARS-CoV-2
Prevalence of genitourinary infection in diabetic patients treated with SGLT 2 inhibitors
Authors: Shrikrishna Acharya , Archana Bhat 
Published: April 2023

Introduction: Genitourinary infections are common in Diabetes patients compared to the general population more so in patients with Sodium glucose co transporter 2 inhibitors (SGLT2i) treatment , So, we did a study to find the prevalence of genitourinary infection in T2DM patients treated with SGLT2i.
Methods: One hundred and twenty patients receiving SGLT2i, who had signs and symptoms indicative of genitourinary infections were enrolled into the study.
Results: The mean age of presentation was 54.4 ± 7.7 years and percentage of males were 62 (51.66%). In this cohort, 72(60%) were treated with empagliflozin, 34(28.33%) with dapagliflozin and 14(11.66%) with canagliflozin. Twenty patients had genital mycotic infection and 4 had urinary tract infection. Female patients had higher incidence of infections than male patients with no statistically significant difference (P = ns). We did not find any significant correlation between age of the patient, gender, duration of disease and treatment, HbA1c, different types and dose of SGLT2i used with the incidence of genital mycotic infections(P = ns).
Conclusion: We need to counsel the patients before starting SGLT2i regarding possible chance of getting genitourinary infection, proper genital hygiene, drinking plenty of water and consulting the doctor if any symptoms at the earliest.
Keywords: Diabetes Complications; SGLT 2 inhibitors; genitourinary infections.
High prevalence of risky sexual behaviour among key populations receiving antiretroviral therapy at a large HIV clinic in northern Uganda
Authors: Adrawa Norbert , Izudi Jonathan , Nyeko Kenneth , Welikhe Emma , Joseph Kizito Bennet , Bajunirwe Francis 
Published: April 2023

Background: Risky sexual behaviour (RSB) among key populations pose a significant risk of human immunodeficiency virus (HIV) infection but remains understudied.
Objectives: We assessed the prevalence and factors associated with RSB among key populations living with HIV (KPLHIV) in the post-conflict region of northern Uganda.
Methods: We designed a cross-sectional study using secondary data, with the outcome as RSB defined as having multiple sexual partners, or condomless sex in the past 3 months, or sexual intercourse with a commercial sex worker in the past 3 months, or sexual intercourse under the influence of substance use in the past 3 months. We used modified Poisson regression to determine factors associated with RSB, reported as adjusted risk ratio (aRR) with 95% confidence interval (CI).
Results: We studied 165 participants and 122 (73.9%) reported RSB and this was more likely among heterosexual females (aRR, 2.39; 95% CI, 1.54-3.71), the married (aRR, 1.92; 95% CI, 1.42-2.49) or separated participants (aRR, 1.47; 95% CI, 1.21-1.79), and transgender persons (aRR, 3.71; 95% CI, 2.05-6.71).Conclusions: RSB is highly prevalent among KPLHIV in northern Uganda so they should be targeted with HIV prevention and behavioural interventions to prevent potential HIV transmission to the general population.
Keywords: Key populations; men who have sex with men; people who inject drugs; commercial sex workers; risky sexual behaviour.
Implementing an intervention to improve leadership/management of public healthcare services in the Free State Province, South Africa: lessons learned
Authors: Malakoane Benjamin , Chikobvu Perpetual , Christoffel Heunis James , Gladys Kigozi Nanteza , Hendrik Kruger Willem 
Published: April 2023

Background: Based on the World Health Organization’s health systems strengthening framework, the Health Systems Governance and Accountability (HSGA) intervention to strengthen public health leadership/management, service integration and outcomes was developed in the Free State.
Objectives: This study describes the process to implement and measure the effects of the HSGA intervention for system-wide improvement of leadership/management under routine conditions in a resource-constrained setting.
Methods: Based on normalisation process theory, participatory discussions were held with health managers, staff and local stakeholders to attain buy-in. Evaluation of the implementation process considered progress in improving leadership/management through application of the Balanced Scorecard (BSC). All provincial reporting units were assessed during 2014/15 and again during 2015/16.
Results: The mean scores on three BSC perspectives improved statistically significantly from 2014/15 to 2015/16: customer (p=0.0085), internal business processes (p=0.0008) and finance (p=0.0001). Overall leadership/management also improved significantly (p=0.0007).
Conclusion: Improvement in leadership/management resulting from implementation of the HSGA intervention was observed during the two years under study. From this experience, successful implementation of a health systems strengthening intervention hinges on a participatory design, appropriate use of theory, as well as application of an evaluation approach to assess the success of implementation.
Keywords: Public health system; intervention; implementation; systems theory; balanced scorecard; leadership/management.
Human herpesvirus-8 infection in Tunisian adult acute leukemia patients
Authors: Handous Imene , Hannachi Naila , Achour Bechir , Marzouk Manel , Hazgui Olfa , Yacoub Saloua , Khelif Abderrahim , Boukadida Jalel 
Published: April 2023

Background: Human herpesvirus 8 (HHV-8) has been linked to the development of Kaposi's sarcoma (KS)and multiple other hematologic malignant disorders. However, the role of HHV-8 in acute leukemia patients is unknown.
Objectives: The objective of this study was to determine the prevalence of HHV-8 in Tunisian acute leukemia patients and in healthy blood donors.
Methods: An indirect immunofluorescence test was used to detect the presence of anti-HHV8 antibodies. Nested PCR was used for the detection of HHV-8 DNAemia in samples of plasma.
Results: The seroprevalence of HHV-8 was significantly higher in acute leukemia patients (21,4% ,15/70) than in healthy blood donors (7,1%, 5/70), (p= 0.02). Gender, type of disease, status of disease, prior blood transfusion, and outcome were not associated with HHV-8 seroprevalence. However, among acute leukemia patients, HHV-8 seroprevalence was statistically associated with older age > 40 years of age, (p=0.002). HHV-8 DNAemia was detected (1,4%) in only one patient of acute myeloid leukemia (AML) and none of the healthy blood donors.
Conclusions: The seroprevalence of HHV-8 infection in Tunisian adult acute leukemia patients was three times as high compared to healthy blood donors, suggesting that patients with acute leukemia might be at increased risk of HHV-8 infection.
Keywords: Human herpesvirus 8; acute leukemia patients; blood donors; prevalence.
Versatility of cervicofacial flap in management of cutaneous cheek defects post tumour excision: a report of two cases
Authors: Ogunkeyede Ayodele , Solagbade Remi , Lawal Adigun 
Published: April 2023

Reconstructing a large cutaneous cheek defect post tumour excision poses a great challenge to the reconstructive surgeon. The surgical options are limited for a functional and aesthetically acceptable outcome. The microvascular free flap which is currently the gold standard is still not a common place in our practice in Nigeria. Cervicofacial flap, a single stage procedure, offers an excellent alternative as it can be done for patients who are not fit for prolonged anesthesia and can even be undertaken under local anesthesia.We presented two cases of patients with cheek tumors who had wide local excision after histological diagnosis of Basal Cell Carcinoma and Basaloid Squamous Cell Carcinoma. Both defects were closed with cervicofacial flap under general anesthesia. The flaps survived with no loss.Cheek defect reconstruction with cervicofacial flap is simple, reliable and with similar favourable aesthetic outcome when compared with free flap procedure. It should be an important part of a reconstructive surgeon armamentarium.
Keywords: Cheek defect; cervicofacial flap; basal cell carcinoma; squamous cell carcinoma; wide local excision.