bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strain in children with MIS-C and acute COVID-19
Authors: Minocha Prashant K. , Srinivasan Ranjini , Babb James , Singh Rakesh K. , Phoon Colin K. L. , Better Donna , Bhatla Puneet 
Published: February 2023

ABSTRACT

Context:
Cardiac injury has been described in both acute COVID-19 and the multisystem inflammatory syndrome in children (MIS-C). Echocardiographic strain has been shown to be a sensitive measure of systolic function.

Aims:
We sought to describe strain findings in both the groups on initial presentation and follow-up.

Settings and Design:
A retrospective study analyzing echocardiograms of all patients presenting with acute COVID-19 infection and MIS-C at our institution between March 2020 and December 2020 was performed.

Subjects and Methods:
TOMTEC software was used for strain analysis in both the study groups (COVID-19 and MIS-C) and age-matched healthy controls. Strain was correlated with LV ejection fraction (EF) and serum troponin levels.

Results:
Forty-five patients (34 – MIS-C and 11 – COVID-19) met the inclusion criteria. There was a statistically significant decrease in LV longitudinal strain (P < 0.001), LV circumferential strain (P < 0.001), and left atrial strain (P = 0.014) in the MIS-C group when compared to the control group. There was a statistically significant decrease in LV longitudinal strain (P = 0.028) in the acute COVID-19 group. All patients with abnormal left ventricular EF (LVEF) had abnormal strain. However, 14 (41%) patients in the MIS-C group and 3 (27%) in the acute COVID-19 group had preserved LVEF but abnormal strain. There was a significant correlation with LV longitudinal strain (P = 0.005) and LVEF (P = 0.002) and troponin in patients with MIS-C. Abnormal strain persisted in one-third of patients in the MIS-C and acute COVID-19 groups on outpatient follow-up.

Conclusions:
Patients with MIS-C and acute COVID-19 can develop myocardial dysfunction as seen by abnormal strain. LV longitudinal strain correlates with cardiac injury as measured by serum troponin in patients with MIS-C. Strain may provide an additional tool in detecting subtle myocardial dysfunction. It can be routinely employed at diagnosis and at follow-up evaluation of these patients.
Subtype and Severity of Stroke at Presentation in Subjects with and without Type 2 Diabetes
Authors: Saifuddin Mohammad , Rahman Md. Mizanur , Sharifuzzaman Mirza , Selim Shahjada , Kamrul-Hasan A.B.M. , Uddin Lt Colonel Nasir , Akter Farhana , Mahbub Mohammad Imtiaj , Ahammed Afsar , Ghosh Debasish Kumar 
Published: February 2023

Background:
Although diabetes is a strong risk factor for stroke, it is still unclear whether stroke subtype and severity at presentation are different in patients with and without diabetes.

Objective:
The objective of the study was to identify the subtype and severity of stroke at presentation in diabetic versus nondiabetic subjects in our population.

Methods:
This cross-sectional comparative study was conducted in the Departments of Neurology and Medicine, Sylhet MAG Osmani Medical College Hospital, Sylhet, from July 2011 to December 2011. Forty-seven stroke patients with diabetes and 47 nondiabetic patients with stroke were included in the study.

Results:
The mean age of the patients of the diabetic group was lower than the nondiabetic group (60.4 [standard deviation (SD) ± 10.5] vs. 65.4 [SD ± 10.3], P< 0.05), but there was no sex difference between the two groups. Hypertension and stroke severity was more in diabetics (Scandinavian Stroke Scale: 21.2 vs. 28.1, P< 0.001). Ischemic stroke was significantly more in the diabetic group than that of the nondiabetic group (83.0% vs. 59.6%, P< 0.01). Subtypes of hemorrhagic stroke and ischemic stroke were almost similar in both the diabetic and nondiabetic groups.

Conclusion:
Stroke in diabetic patients is different from stroke in nondiabetic patients in several aspects. The diabetic stroke patient is younger, ischemic stroke and stroke severity is more, but hemorrhagic stroke is less in diabetic individuals.
Treatment Outcome of Occlusion for Unilateral Amblyopia in Saudi Children 6-12 Years Old
Authors: Sesma Gorka , AlMairi Tasnim , Khashoggi Heba , Aljohar Fahad , Khandekar Rajiv , Awad Abdulaziz 
Published: February 2023

PURPOSE:
The purpose of this study was to estimate the rate and review determinants of successful therapy for unilateral amblyopia in children.

METHODS:
This prospective cohort consisted of Saudi children aged 6–12 who received amblyopia therapy between 2020 and 2022. Best-corrected visual acuity (BCVA) in the amblyopic eye improved to reach the BCVA of the fellow eye at follow-up visits, or BCVA in the amblyopic eye improved and remained stable over three follow-up visits. Demographic and ocular characteristics were associated with the outcome.

RESULTS:
In 30 children, the median BCVA at presentation and the last follow-up was 0.8 logMAR (interquartile range [IQR]: 0.6; 1.0) and 0.45 logMAR (IQR: 0.3; 0.6), respectively. The success rate of amblyopia therapy was 80% (95% confidence interval: 65.7; 94.3). It was 100%, 76.5%, and 77.8% in eyes with anisometropic, strabismic, and mixed types of amblyopia, respectively. Amblyopia grade (P = 0.177), type of amblyopia (P = 0.96), and spectacles as therapy in the past (P = 0.09) were not significantly associated with the successful out. The duration of follow-up was significantly longer in those with unsuccessful outcomes (P = 0.05). Excellent compliance for occlusion was observed in 62.5% of children with successful outcomes. In 14 (46.7%) children, BCVA was ≤0.3 logMAR BCVA at the last follow-up. Two-line improvement in amblyopic eyes was in 26 (86.7%) children at the last follow-up compared to BCVA at presentation.

CONCLUSION:
Occlusion therapy complemented using glasses in older children also significantly improved visual recovery in amblyopic eyes.
Comparison of Glaucoma Therapy Escalation After Penetrating Keratoplasty to Descemet Stripping Automated Endothelial Keratoplasty for the Treatment of Pseudophakic Bullous Keratopathy: A Cohort Study
Authors: Aldarrab Abdulrahman , Alsakran Wael , Al-Swailem Samar A. , Al-Shahwan Sami A. 
Published: February 2023

PURPOSE:
The purpose of this study was to compare glaucoma therapy escalation (GTE), graft survival, vision, and glaucoma following penetrating keratoplasty (PK group) and Descemet stripping automated endothelial keratoplasty (DSAEK group) to treat pseudophakic bullous keratopathy (PBK).

METHODS:
This cohort included cases of PBK managed with PK from 2009 to 2014. We compared the incidences and determinants of GTE, graft survival, and visual disability. P < 0.05 was statistically significant.

RESULTS:
There were 58 eyes in the PK group and 117 eyes in the DSAEK group. The incidence of GTE in the PK and DSAEK groups at the last follow-up was 34.2% (95% confidence interval [CI]: 19.5–48.9) and 46.6% (95% CI: 27.7–65.4), respectively. The risk of GTE was similar between the groups (relative risk [RR] = 1.36 [95% CI: 0.94–1.98], P = 0.12). GTE was significantly associated with graft survival in the PK group (RR = 3.25 [95% CI: 1.5–7.0], P < 0.001) and the DSAEK group (RR = 3.77 [95% CI: 2.6–5.6], P < 0.001). Glaucoma (P = 0.001) and previous keratoplasty (P < 0.001) were significant predictors for GTE. At the final follow-up visit, severe visual disability was not significantly different between the groups (RR = 0.9 [95% CI: 0.3–2.9], P = 0.88). There was a statistically significant improvement in vision after DSAEK (P < 0.001) but not after PK (P = 0.67).

CONCLUSION:
GTE was similar in eyes with PBK managed by PK or DSAEK. Glaucoma and previous keratoplasty were predictors of GTE post-keratoplasty. DSAEK gave better visual outcomes than PK for managing PBK.
Effect Biofilm Formation in Pseudomonas aeruginosa Resistance To Antibiotic
Authors: Shatti Hanan Hameed , Al-Saeed Wisam M. , Nader Mohammed I. 
Published: February 2023

Objective:
Due Pseudomonas aeruginosa is the most common type of bacteria that causes hospital-acquired infections because it has multiple resistance mechanisms to antibiotics such as biofilm formation. It is important to understand to investigate biofilm production in multidrug resistant clinical isolates of P. aeruginosa from different sites of infection.

Materials and Methods:
This work was done on 114 patients were collected from different specimens From hospitals Baghdad. The collected samples were cultured on different media (blood agar, MacConkey agar, nutrient agar, and Cetrimide agar) for isolation of P. aeruginosa bacteria as well as isolates from all patient were tested for antimicrobial susceptibility using disk diffusion method, in vitro formation of biofilm in microtiter plates containing Muller –Hinton broth.

Results:
Forty specimens (35.1%) were observed to have bacterial growth (positive samples) for P. aeruginos, the results of P. aeruginosa isolates were tested for antibiotic susceptibility showed that among forty positive results, the most isolates were potentially resistant to different antibiotics presented that the isolates resistant to piperacillin (34, 85%), gentamicin (26, 65%), tobramycin (30, 82.5%), amikacin (27, 67.5%), cefepime (25, 62.5%), meropenem (31, 77.5%), carbenicillin (31, 77.5%), ceftriaxone (30, 75%), ciprofloxacin (27, 67.5%), imipenem (22, 55%), ceftazidime 26 (65%), and norfloxacin 24 (60%). The results showed the ability of P. aeruginosa isolates to produce biofilm were 40 (100%) has the ability to produce biofilm, these were the result divided in to strong 19 (47.5%), moderate 12 (30%), and weak 9 (22.5%).

Conclusion:
There were 40 isolates biofilm producers in divers levels of biofilm strength.
Hepatoprotective Effects of Pomegranate Against Methotrexate-Induced Acute Liver Injury
Authors: Al-Gareeb Ali Ismail , Mohammed Ghaith Faris 
Published: February 2023

Background:
Methotrexate (MTX) is a synthetic antimetabolite with a wide range of clinical applications, but its liver toxicity induced mainly through oxidative stress represents a primary concern on its clinical use. Pomegranate fruit contains many polyphenolic compounds that possess potent antioxidant effects and, therefore, have a possible hepatoprotective effect.

Objectives:
This study seeks to address the hepatoprotective effects of pomegranate against MTX-induced liver injury.

Materials and Methods:
Twenty-eight healthy female albino mice were grouped into four groups; control and MTX groups received oral 0.5 ml distilled water, while; the PG150 group received 150mg/kg oral pomegranate, and the PG300 group received 300mg/kg oral pomegranate. The oral course continues for 10 days, and on the last day, all groups were injected with 20 mg/kg MTX intraperitoneally, except the control group injected with normal saline. 48-hours later, samples were collected and prepared for biochemical and histopathological evaluation.

Results:
After biochemical analysis, MTX causes an elevation in serum Alanine aminotransferase, Lactate dehydrogenase, and liver tissue malondialdehyde, indicating hepatic injury, while pomegranate pre-treatment will hold down this elevation significantly and dose-dependently, causing amelioration of the toxic effect of MTX; the histopathological findings support this finding. Also, MTX causes consumption of liver tissue content of superoxide dismutase (SOD) and Glutathione (GSH), while pomegranate pre-treatment boosts the SOD and GSH hepatic tissue level.

Conclusion:
Pomegranate has a dose-dependent amelioration effect on the toxic effect of MTX on the liver.
Cosmetic and Functional Outcomes of Single-Stage Feminizing Genitoplasty in Children with Congenital Adrenal Hyperplasia
Authors: Salim Moamin Junaid , Al-Mayoof Ali Farooq , Joda Ali Egab , Almushhadany Osama Ismael 
Published: February 2023

Introduction:
Evaluating the cosmetic and functional outcomes in girls with congenital adrenal hyperplasia (CAH) is essential to criticize the effectiveness of single-stage feminizing genitoplasty (SSFG).

Objective:
The aim of this study is to evaluate the outcomes of SSFG in terms of cosmetic and functional results for girls with CAH.

Materials and Methods:
A prospective study involves the performance of SSFG for patients with CAH in two pediatric surgery centers for a period of 9 years. The surgical procedure was either total or partial urogenital mobilization. The cosmetic and anatomical outcomes were evaluated according to Creighton criteria as good, satisfactory, and poor. The patients were followed up for 4–9 years.

Results:
The study included 55 girls with CAH, the mean age at operation was 4.1 ± 1.2 years. Most of cases are prader Stage II (42%). Total urogenital mobilization was performed in 74.5% of patients. Vaginal stenosis was the most common complication (11%). Urinary incontenance registered in 3 cases. The cosmetic and functional outcome was good in (65.5%), satisfactory (21.8%), and poor in (12.7%).

Conclusion:
Early SSFG is effective in providing good cosmetic and functional outcome in patients with CAH.
Assessment of the Left Ventricular Performance in Hypertensive Patients with Normal Coronary Angiography and Ejection Fraction
Authors: Fadhil Safaa Hasan , Elaebi Hachim Rasan , Abbas Shakir Khudhair 
Published: February 2023

Aim:
To evaluate the validity of the longitudinal speckle tracking echocardiography (STE) in the detection of early changes in the performance of the left ventricle for hypertensive patients with normal ejection fraction (EF) and coronary angiography.

Patients and Methods:
A case-control study enrolled 50 patients and a randomly collected control group of 30, who consulted Ibn-Albitar Cardiac Center from November 2016 to the first September 2017. The patients had hypertension while the control did not. Both had normal coronary angiography, assessed by conventional echocardiography, two-dimensional STE, and anthropometric measures.

Results:
The mean age for the patients or cases was 52.48 ± 4.292 years, and their mean body mass index (BMI) was 30.10 ± 1.854 kg/m2. They had been diagnosed with hypertension for a mean duration of 8.14 ± 3.326 years. All were on treatment; the mean left ventricular (LV) mass was 108.96 ± 19.469 (g/m2) while the mean global longitudinal strain (GLS) was −16.720 ± 3.191. There was an approximately equal number of males and females among the cases: 24 (48.0%) and 26 (52.0%), respectively. Twenty-seven (54.0%) had LV hypertrophy (LVH), and only 4 (8.0%) cases had diastolic dysfunction with GLS −12. The mean age of the controls was 55 ± 4.792 years, and their BMI was 30.77 ± 2.063 kg/m2. They had a mean LV mass of 92.50 ± 10.058 (g/m2) and their GLS was slightly lower (more negative) than the cases, at −17.517 ± 2.222. Thirteen controls were males (43.3%) while 17 (56.7%) were females. Only 2 (6.7%) had diastolic dysfunction with GLS −14. GLS was significantly higher (less negative) in the cases with LVH compared to the controls: 15.278% compared to −17.517% respectively, with a mean difference of −2.238%. There was no statistically significant difference between controls and cases without LVH.

Conclusions:
The use of STE is beneficial in the detection of subtle changes in the LV of hypertensive patients with normal coronary angiography and normal EF.
Trocar blade-assisted skewer technique for phacoemulsification of a dislocated lens
Authors: Liu Laura , Hwang Yih-Shiou , Wu Wei-Chi , Lai Chi-Chun , Liu Jorn-Hon 
Published: February 2023

Abstract:
A posteriorly dislocated lens is often managed with a fragmatome through a pars plana approach because it is difficult to manage anteriorly. The lens often sinks to the surface of the retina or floats around in the vitreous cavity during pars plana lensectomy. Mechanical trauma can occur while removing the dislocated lens fragments. However, sometimes the lens can be confined to the anterior vitreous cavity even though the zonules are completely disrupted. It would be ideal if there was a simple way to stabilize and support the lens so that the lens could remain in the posterior chamber while phacoemulsification is performed through a corneal incision as usual. We describe a technique using a trocar blade to stabilize the lens while performing phacoemulsification through a corneal incision. We found it to be a useful and safe instrument to support the subluxated lens during phacoemulsification.
Metaphysical grounding
Authors: Bliss Ricki 
Published: February 2023

Reality would appear to contain many different kinds of things: peonies, storms, facts, numbers, heartaches, and then some. And the contents of this reality would seem to stand in any manner of relations to other of its contents. Peonies might cause Maxine to sneeze, numbers could be considered constituents of the facts about them, and heartaches may well supervene on complex configurations of emotional states. In addition to relations such as identity, parthood, causation, supervenience, instantiation, membership, and so on, many philosophers think we ought also to include relations of grounding.
So, what exactly is grounding? We might say, for example, that facts about wholes are grounded in facts about their parts, that what’s good is grounded in what’s right, that sets are grounded in their members, and that the mental is grounded in the physical. These are but a few examples. In each case, we do not wish to claim that the one causes the other: members don’t cause the sets of which they are members to exist. But in each case, we do want to say that there is some particularly important and tight metaphysical connection between the two; a connection even tighter than mere modal correlation. Indeed, we might think that even though the moon and the singleton set of which it is the sole member come hand in glove – every world at which the moon exists its singleton exists and vice versa – the singleton seems to depend upon the moon in a way in which the moon does not depend upon the singleton.
When telling the story of the world, thinks the metaphysician of a certain stripe, we need the notion of grounding. Perhaps nowhere, though, is the notion more central than in providing us with the metaphysical means to vindicate a particular picture of the overarching structure of reality. Consider the universe. The universe depends upon its constituents: galaxies, solar systems, planets, stars, and so on. Indeed, the universe appears to depend not only on its really big parts, but also on its really small ones as well: quarks, protons, and so on. Amongst the constituents of the universe, we can also discern a dependence ordering: the big things – galaxies, etc. – depend upon the small things – electrons, etc. Reality, it would seem, is hierarchically structured.
This view, although very old, receives its contemporary expression in the language of metaphysical grounding. According to a very common view, reality is hierarchically structured by relations of ground that are asymmetric, transitive, and irreflexive. According also to this view, chains of entities ordered by those relations terminate in something fundamental. The Great Chain of Being involves reality and its parts arranged by relations of grounding.
This entry is about metaphysical grounding, and the picture of reality that it is intimately associated with.
CANDIDÍASE VULVOVAGINAL ENTRE ACADÊMICAS DE MEDICINA DO OESTE DO PARANÁ
Authors: Pereira Carvalho Kethellyn Dayanne , Possobon Adriano Luiz 
Published: February 2023

Este estudo teve por objetivo analisar a prevalência de vulvovaginite (VVG) por Candida entre acadêmicas do 1º ao 6º ano do curso de medicina em um Centro Universitário particular do interior do Paraná. Estudo transversal, exploratório, descritivo, com foco em levantamento de dados mediante aplicação de questionário pela plataforma Google Forms® em acadêmicas de medicina do 1º ao 6º ano em uma universidade privada do Oeste do Paraná. Responderam a pesquisa 81 acadêmicas distribuídas por todos os anos do curso. A maioria apresentou idade entre 21 e 25 anos. Das entrevistadas, 27% afirmaram nunca terem tido VVG por Cândida, as demais 73% responderam positivamente. Quando questionada a situação vivenciada pela estudante durante o aparecimento da candidíase, 29,3% das causas informadas foi a correlação entre problemas na faculdade e o aparecimento da VVG, seguido de nenhuma correlação com 23,9%. A maioria (53%) afirmou utilizar contraceptivo oral. As participantes relataram a presença de 12 sintomas, sendo entre eles, o prurido o mais frequente (22%). E ainda, sobre formas de prevenir a VVG, 47 (59%) entrevistadas responderam saber sobre métodos preventivos e 34 (41%) assinalaram desconhecer. Neste contexto o presente estudo sugere que a VVG é uma condição prevalente no ambiente acadêmico, que este ambiente pode ser um fator desencadeante e que medidas educativas devem ser implementadas no sentido de prevenir esta condição. Além disso cabe a todos os profissionais de saúde contribuírem para disseminação de informação acerca do estilo de vida e modos de prevenção desta patologia.
DIÁLOGO ENTRE FREIRE E LÉVINAS COMO ESTRATÉGIA DE RESPONSABILIDADE E RESPEITO AO OUTRO NA EDUCAÇÃO
Authors: Santos Ben-Hesed , Garcia Elaine França Holanda , Silva Luzia Batista de Oliveira 
Published: February 2023

O artigo objetiva analisar, no campo da filosofia e da educação, o diálogo como uma estratégia de responsabilidade e respeito ao saber do outro, docentes e discentes. Para fundamentar a discussão, recorreu-se às contribuições filosóficas de Emmanuel Lévinas, nas obras em que a palavra pode ser entendida como a origem da significação dos instrumentos das obras humanas, porque, é mediante a origem da significação que o sistema de reenvio reduz toda significação que recebe o princípio do seu fundamento, a sua chave, que nos aproxima da obra do filósofo e educador Paulo Freire e das contribuições ao campo da educação. Em Paulo Freire, a concepção de diálogo aparece não só como um encontro de dois sujeitos que buscam o significado das coisas - o saber – mas, também, como um encontro que se realiza na práxis – ação-reflexão, no engajamento, no compromisso com a transformação social. E partir daí, conceber o diálogo como uma estratégia fundamentada na outreidade enquanto fundamento da justiça e da ética ou, dito de outra maneira, como fundamento ético reconhecendo-o como princípio-fundamento da própria Filosofia, entendida a partir da responsabilidade fraterna face a face, ou seja, a capacidade de realização da justiça e da humanidade fraternal. O diálogo propicia o encontro do Mesmo com o Outro no qual o Mesmo não se reduz ao Outro, à mesmidade, mas, ao contrário, ouve sua fala, diz sua fala. Não há diálogo, porém, se não há um profundo amor ao mundo e aos homens. Não é possível a pronúncia do mundo, que é um ato de criação e recriação, se não há o amor que a infunda, assevera Freire. Sendo fundamento do diálogo, o amor ao Outro é diálogo consigo, com o outro e com o mundo.