bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Endoscopy Decrease the Length of Hospital Stay and the Costs in Patients with Upper Gastrointestinal Bleeding
Authors: Arslan E , Ozakin E , Temel T , Ozakyol AH , Acar N , Kaya FB , Canakci ME , Çağlayan T 
Published: August 2023

ABSTRACT

Background:
Acute gastrointestinal (GI) bleeding is a common cause of hospitalization. There are conflicting results regarding the effectiveness of early endoscopy in patients with upper GI bleeding.

Objective:
The study aimed to determine the benefit of early endoscopy and the epidemiological characteristics of patients presenting to the emergency department with non-variceal acute upper GI bleeding.

Methods:
Patients over 18 years of age who presented to the emergency department with upper GI between 2015 and 2016 and underwent endoscopy were included in the study. The patients were divided into two groups: early endoscopy group (endoscopy within the 24 h) and late endoscopy group (endoscopy after 24 h).

Results:
Of 104 patients, 57.7% were man, and the mean age was 66.27 ± 17.64 years. Of the patients who underwent endoscopy, 80 (76.9%) were in the early endoscopy group. There was no difference in blood transfusion needs (P = 0.388), re-bleeding (P = 0.137), the need for surgery, and mortality rates with regard to the timing of endoscopy. The results of the receiver-operating characteristics curve analysis revealed patients with a GBS ≥ 9 were taken as high-risk, and a prognosis analysis was performed accordingly. However, in patients undergoing early endoscopy, a difference was detected with respect to the length of hospital stay (P = 0.011) and treatment costs (P = 0.030). In the comparison with the admission time (working/non-working h) and variables, there were no significant differences in the length of hospital stay (P = 0.230), transfusion needs (P = 0.348), re-bleeding frequency (P = 0.905), and treatment costs (P = 0.094).

Conclusion:
Endoscopy within 24 h in the setting of acute upper non-variceal GI bleeding is associated with an increase in the length of hospital stay and treatment costs, but is not associated with re-bleeding, transfusion needs, need for surgery, and mortality.
Trends and Burden of Hepatitis B Viral Infection in Children and Adults in a Tertiary Health Facility in North East Nigeria Over a Fifteen-year Period
Authors: Isaac WE , Jalo I , Ajani A , Oyeniyi CO , Abubakar JD , Aremu JT , Danlami MH 
Published: August 2023

ABSTRACT

Background:
Hepatitis B infection is endemic in Nigeria where greater than six percent of the general population are chronic carriers. Transmission predominantly occurs in infants and children when compared with adults. Viral hepatitis deaths are mostly due to chronic liver disease. Routine immunization against hepatitis B virus infection in Nigeria is still low.

Aims:
We planned to describe the burden and trend of hepatitis B viral infection at Federal Teaching Hospital, Gombe.

Methodology:
This study was a retrospective cross-sectional descriptive study. The results of all hepatitis B surface antigen (HBsAg) tests using rapid chromatographic immunoassay performed at the Federal Teaching Hospital, Gombe (FTHG), Nigeria from January 2000 to December 2014 were retrieved and analyzed.

Results:
Between 2000 and 2014, 23,611 individuals ranging from 2 months to 98 years of age were tested for HBsAg. A total of 13,136 (55.6%) were males and 10,475 (44.4%) were females. Among individuals tested for hepatitis B surface antigen, 18.9% (4,456) were positive. A total of 70.6% (3,147) were males and 29.4% (11,239) were females. Male sex was significantly associated with HBsAg positivity (P < 0.001). The mean HBsAg prevalence over the 15-year periods among males and females were 22% and 12%, respectively (P < 0.001). The mean yearly HBV prevalence was 17.5%, 17.2%, 19.6%, 15.5%, and 4.4% among age-groups 0–18 years, 19–25 years, 26–45 years, 56–65 years, and >65 years, respectively (P = 0.132). The proportion of HBsAg-positive individuals was highest in the year 2012 (28.7%) and lowest in 2014 (1.8%).

Conclusion:
There was an increasing trend in HBV testing and diagnosis in children and adults in our facility over the last 15 years. Health facility capacity for HBV treatment and care requires strengthening
Coronary Artery Bypass Surgery without Blood Transfusion; is it Possible?
Authors: Aykut K , Albayrak G , Cetin Y , Ciftci N , Ciftci S 
Published: August 2023

Background:
Coronary artery bypass surgery is the most commonly performed cardiac operation and approximately 40-70% of patients require a blood transfusion despite improvements in cardiac surgical techniques. Some preventive perfusion methods to avoid transfusions are described, such as acute normovolemic hemodilution, retrograde autologous priming, and usage of integrated arterial filter oxygenator.

Aims:
We combined these three techniques (triple combination technique) to evaluate whether it is possible to avoid blood transfusions in adult patients undergoing coronary artery bypass surgery.

Materials and Methods:
A total of 300 consecutive patients were included in this randomized controlled trial. 150 patients (Group 1) were operated with triple combination technique, The other 150 patients (Group 2) were operated with standard cardiopulmonary bypass technique. The two groups were compared in terms of peroperative and postoperative blood product use.

Results:
Ninety-two percent (92%) of the patients (Group 1) undergoing coronary artery bypass surgery did not require any blood transfusion. Only 8% of the patients required erythrocyte suspension or fresh frozen plasma transfusion. In Group 2, 58% of patients required blood transfusions. The difference between two groups was statistically significant (p < 0,05).

Conclusion:
Triple combination technique is safe and cost-effective in coronary artery bypass surgery. We think that most of the patients could be operated without blood transfusion with this technique.
The Impact of Infertility on the Sexual Life of Infertile Women in Enugu, South East Nigeria
Authors: Ndubuisi VA , Ezugwu EC , Chigbu CO , Ekwuazi KE , Onwuka CI 
Published: August 2023

ABSTRACT

Background:
Infertility is a common gynecological problem in sub-Saharan Africa, including Nigeria. It tends to affect the sexual life of couples and may affect their quality of life.

Objective:
The study was aimed to assess the impact of infertility on the sexual life of women with infertility seeking care in Enugu, South-East Nigeria.

Methods:
A questionnaire-based, multicenter cross-sectional study of women with infertility managed at the Gynecology units of the two government-owned tertiary hospitals in Enugu over a 2 months period. The relevant data were obtained and analyzed using SPSS version 20.0.

Results:
Three hundred and sixty female respondents participated in the study. Their mean age was 35.23 ± 5.7 years. The majority of them were married (98.3%) and attained a tertiary level of education (69%). The number of respondents that reported adequate sexual intercourse dropped from 33.9% before the diagnosis of infertility to 12.2% after the diagnosis. Almost two-thirds of the respondents (65%) reported that they no longer enjoy sex with their husband/partner, whereas 38.9% of them feel they were no longer attracted to their partners.

Conclusion:
Infertility seems to have a negative effect on the sexual life of women. Addressing this identified negative effect may improve the outcome of infertility management and also may improve the quality of life of women with infertility in the region.
Generalized Eruptive Syringoma in a Nigerian Woman
Authors: Yahya H 
Published: August 2023

ABSTRACT
Generalized eruptive syringomas are a very rare variant of syringoma which appear on the chest, neck, abdomen, upper and lower arms, thighs, legs and back. They often affect adolescent or post-adolescent females, although cases have been described in children and older adults. Generalized eruptive syringomas are mostly sporadic but familial cases, and those associated with eczematous skin conditions, solid organ transplants, renal cell carcinoma and some genodermatoses have also been reported. Although eruptive syringomas may resemble cutaneous mastocytosis, disseminated granuloma annulare, eruptive xanthomata, steatocystoma multiplex, eruptive velus hair syndrome, verruca plana and other skin conditions clinically, the histological appearance characterized by upper dermal epithelial cords with a tendency to ductule formation and tadpole extension of outer epithelial layer is diagnostic. We report the case of a 20-year-old Nigerian woman with generalized eruptive syringoma.
Changing Susceptibility Pattern of Neisseria Gonorrhoeae
Authors: Jimoh O , Aliyu S , Ejembi J , Abdulaziz MM , Ibrahim M , Ibrahim A , Olayinka AT 
Published: August 2023

ABSTRACT
Gonorrhoea is a sexually transmitted infection (STI) that increases the risk of infection with human immunodeficiency virus (HIV) and causes infertility and urethral stricture. We describe three cases of sexually active men, otherwise stable, who presented with a history of painful micturition and creamy white, urethral discharge. A clinical diagnosis of gonococcal urethritis was made and confirmed by microscopy, culture and 16SrRNA. Antimicrobial susceptibility revealed resistance to all the antimicrobial agents tested including ceftriaxone. A dual therapy was initiated using ceftriaxone and azithromycin, but at a higher dose for the patient with multi-drug resistant (MDR) Neisseria gonorrhoeae. Patients did well and were followed up for 5 months. Contact tracing was done for their sexual partners. While it is also important for healthcare workers to familiarize themselves with current treatment guidelines for gonococcal urethritis, the place of clinical laboratory in the management of STIs, with molecular techniques and the need for surveillance for MDR Neisseria gonorrhoeae cannot be overemphasized.
Nitric Oxide in Infertile Females in the Niger-Delta Region of Nigeria
Authors: Okhionkpamwonyi O , Okonta PI , Okoacha I , Idogun S 
Published: August 2023

ABSTRACT

Background:
Infertility is a public health challenge and it is a distressing personal tragedy for couples, more so for the female partners. Risk factors and causes of infertility vary from region to region. Reactive species is of current interest in the pathogenesis and management of infertility, especially in the Niger-Delta Region of Nigeria where environmental hazards of oil exploration exists.

Aim:
The overall goal of this study was to determine and compare the serum reactive species levels (nitric oxide) in fertile and infertile women attending the infertility clinic at the Delta State University Teaching Hospital, Oghara, and Central Hospital, Warri.

Methods:
This was a prospective case-control study in which 70 women evaluated for infertility were recruited into the study. A fertile patient matched for age and body mass index (BMI) attending family planning clinic was selected as control. Serum nitric oxide estimation was done using the BioVision Nitric Oxide Colorimetric Assay Kit. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS). Student's t-test was applied to compare the serum levels of nitric acid and the differences were considered significant if P < 0.05.

Results:
Infertile women had significantly higher mean serum nitric oxide levels than fertile women: 34.33 (SD 5.93) μmol/L versus 18.27 (SD 2.63) μmol/L (P < 0.001). Women with secondary infertility had significantly higher mean levels of nitric oxide than those with primary infertility: 38.13 (SD 3.39) μmol/L versus 22.72 (SD 4.36) μmol/L (P < 0.001).

Conclusion:
The study showed that serum nitric oxide level was significantly elevated in women with infertility compared to women of proven fertility. Hence, oxidative stress from reactive species may be a contributory factor to infertility in women in the Niger-Delta Region of Nigeria.
Health-Related Quality of Life in Children and Adolescents with Epilepsy in Enugu
Authors: Aronu AE , Uwaezuoke N , Chinawa JM , Bisi-Onyemaechi A , Ojinnaka NC 
Published: August 2023

Background:
Epilepsy, a chronic brain disorder, predisposes children to low Health-Related Quality of Life (HRQOL).

Objective:
This study aimed at assessing the HRQOL in Nigerian children with epilepsy and compare it with that in healthy children.

Methods:
A cross-sectional study of 166 children with epilepsy (CWE), aged 5–18 years on anti-epileptic drugs (AEDs) for at least 6 months and 166 age and sex–matched apparently healthy children was conducted. A generic version of the Pediatric Quality of Life (Peds QoL version 4) scale was used to assess HRQOL.

Results:
There were significant differences in Quality-of-Life mean scores in the domains of social functioning, psychosocial combination, and psychosocial plus physical activities between cases and controls. The school function scores of <50, indicating low QOL, were significantly more (Chi square = 35.37) (P = 0.0001) among the cases (32.5%) compared to the controls (6.3%). Similarly, low quality of life in the psychosocial combination were observed significantly (P_ = 0.042) more among the cases (12.7%) compared to the controls (6.3%). Low quality of life in emotional feeling domain were noted significantly (Chi square = 12.9) (P = 0.0002) more in subjects aged between 8 and 12 (20%). QOL scores of below 50 in the social function domain were observed significantly (Chi square = 6.49) (P = 0.039) more in subjects aged between 5 and 7 years (44.8%). There was significant gender difference in Quality-of-life index in school functioning domain in subjects. (Chi Square = 6.49) (P value = 0.039). Children in the upper social class scored higher in the social functioning domain, and social class was significantly associated with scores in the social domain of functioning. (F = 3.75 and P = 0.03). QOL scores below 50 in the emotional domain were significantly more among subjects aged 8–12 years/13–18 year, s and QOL scores of <50 in the school function domain were significantly more in subjects aged 5–7 years. (P = 0.0002) (P = 0.039), respectively.

Conclusion:
HRQOL is reduced in CWE in all domains of Peds QoL. Significant predictors of reduced HRQOL include age, gender, and socioeconomic class. Beyond seizure control, epilepsy management should be oriented towards ensuring the optimal health-related quality of life.
Comparison of the Treatment Outcomes of the Conventional Stainless Steel Crown Restorations and the Hall Technique in the Treatment of Carious Primary Molars
Authors: Ayedun OS , Oredugba FA , Sote EO 
Published: August 2023

Background:
Dental caries is a multifactorial disease that causes reversible decalcification and cavitation of susceptible teeth exposed to sugary substrates over a period of time in the oral cavity. It gives clinical and social burdens to the child patients and their parents/carers. Stainless steel crown (SSC) restoration is one of the restorative treatment options in the management of carious primary molars.

Aims:
The Hall technique is a biologic method of managing primary teeth by sealing in the caries with preformed metal crowns (SSCs). The objectives of this study were to assess and compare the primary and secondary treatment outcomes of stainless steel crown restorations using the conventional method and the Hall technique in primary molars immediately after placement and over a 12-month period using both clinical and radiological parameters.

Methods:
The study was a randomized control clinical trial using a split mouth approach. A total of 25 stainless steel crown restorations using the conventional method and 25 stainless steel crown restorations using the Hall technique were placed in 25 subjects aged 3–8 years with a pair or pairs of unrestored enamel or dentinal carious primary molars matched for tooth type, dental arch, and extent of caries. All subjects were monitored and reviewed every 3 months for 12 months.

Results:
Twenty three subjects returned for follow-up. There was no statistically significant difference (P-value > 0.05) between the conventional SSC restoration and the Hall technique for both the primary outcomes/major failures (irreversible pulpitis, dental abscess, peri-radicular radiolucency, and crown loss with tooth unrestorable) and secondary outcomes/minor failures (crown loss and tooth restorable, crown perforation, secondary/marginal caries, and reversible pulpitis). But, there was a statistical significant difference in the average time taken for the placement of the restorations between the two groups (P-value 0.001).

Conclusion:
Both the conventional SSC restorations and the Hall technique can be provided for all the subjects in this study. The Hall Technique compared favorably well with the conventional SSC restoration in clinical and radiological outcomes. The Hall Technique appears to offer an effective treatment option for managing dental caries in primary molar teeth especially in a resource challenged environment where electricity and treatment under general aaesthesia can sometimes be a problem.
Prevalence and Risk Factors for Hepatitis B and C Among End-stage Renal Disease Patients on Hemodialysis in Gaborone, Botswana
Authors: Mahupe P , Molefe-Baikai OJ , Saleshando G , Rwegerera GM 
Published: August 2023

Background:
Patients on maintenance hemodialysis (HD) are at risk of blood transmitted infections such as hepatitis B and C.

Objectives:
To determine the prevalence and risk factors for hepatitis B and hepatitis C virus infections among end-stage renal disease (ESRD) patients on maintenance hemodialysis in Gaborone, Botswana.

Materials and Methods:
A cross-sectional study with a retrospective longitudinal approach involving all eligible public patients undergoing hemodialysis was carried out for a period of 3 months. Data on socio-demographic, clinical characteristics, and hepatitis serology was collected using a case report form. Statistical Software Package for Social Sciences (SPSS) version 24 was used for data entry, cleaning, and analysis. The risk factors associated with Hepatitis B and C infections were determined using bivariate logistic regression analyses. A P value of less than 0.05 was considered statistically significant.

Results:
Of the 168 participants, 5 (2.98%) were HBsAg seropositive at the initiation of hemodialysis, whereas 2 (1.19%) were seropositive for anti-HCV antibodies at the initiation of hemodialysis. Two patients out of 163 (1.23%) were found to have seroconverted to HBsAg positivity during hemodialysis. One out of 166 patients (0.61%) seroconverted to HCV antibodies positivity during hemodialysis. The duration of hemodialysis, history of invasive procedures, HIV status, frequency of hospitalization, and blood transfusion were not associated with seroconversion for both Hepatitis B and C.

Conclusions:
The prevalence hepatitis B and C infections among ESRD patients on hemodialysis is low. There was no significant association between the identified risk factors and HBV/HCV infection. Regular audits on seroconversion status for hepatitis B and C are recommended as a way of assessing and supporting the current strategies for infection control among HD patients.
A Comparison of Intralesional Verapamil and Triamcinolone Monotherapy in the Treatment of Keloids in an African Population
Authors: Belie O , Ugburo AO , Mofikoya BO , Omidiji OAT , Belie MF 
Published: August 2023

ABSTRACT

Background:
Keloid is a fibroproliferative disorder of dermal origin, common and severe in the dark-skinned individuals. The patients suffer from pain and pruritus with poor body image.

Aims:
We compared the efficacy and side effects of intra-lesional verapamil and triamcinolone in patients with keloids. As most treatments are cumbersome, recurrence is a major problem despite the many treatment modalities. There is need for effective monotherapy with minimal complications.

Materials and Method:
This is a prospective, randomized study of intralesional injection of verapamil and triamcinolone in keloids conducted in the Burns and Plastic unit of a tertiary hospital. There were two groups; triamcinolone treatment group (TTG) and verapamil treatment group (VTG). A total of 115 patients with keloids <10 cm were diagnosed, 37 (32.2%) were excluded, and 78 were included into the study. There were 40 patients in the TTG and 38 patients in the VTG. Eventually, 70 patients completed the study. Triamcinolone 40 mg and 2.5 mg of verapamil were used for TTG and VTG respectively. The changes in the dimensions of keloids were measured using an electronic caliper. The symptoms were assessed using the visual analog score for pain and the pruritus score was adapted from the 5-D pruritus score.

Results:
Triamcinolone completely resolved pain and pruritus in 6 and 12 weeks, respectively, while there was no complete resolution among VTG patients. However, verapamil injection was comparably effective to triamcinolone for small-size keloids.

Conclusion:
Verapamil as monotherapy is less efficaceous in the resolution of symptoms of keloids but is comparable to triamcinolone in reducing the size of small-sized keloids.
Pedicle Screw Fixation with Percutaneous Vertebroplasty for Traumatic Thoracolumbar Vertebral Compression Fracture
Authors: Sezer Can , Sezer Cenk 
Published: August 2023

ABSTRACT

Objective:
This study aims to evaluate the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) for the treatment of the thoracolumbar vertebral compression fracture (VCF) without neurologic deficits.

Materials and Methods:
This was a prospective observational study. Between January 2015 and December 2018, 62 patients who had suffered from traumatic thoracolumbar (VCF) burst fractures without neurologic deficits were included in this study. The patients were divided into two groups as follows: patients who underwent PPSF combined with PVP (PPSF-PVP Group; n = 24) and patients who underwent only PPSF (PPSF Group; n = 38). The patients were (PPSF and PPSF-PVP Group) followed up for more than 9 months. The kyphotic angle, compression ratio, and visual analog scale (VAS) score for back pain were analyzed and compared between the two groups.

Results:
The patients were followed up for an average of 9.1 months. Hospital stay significantly decreased in PPSF-PVP Group (P < 0.001). The median VAS score significantly decreased after the surgery in both the groups (P < 0.005), and mean VAS scores in PPSF-PVP Group were significantly lower than those in PPSF Group. No significant (P > 0.005) changes in local kyphosis and the vertebral body height gains obtained at the end of the follow-up period in PPSF-PVP Group. However, local kyphosis increased significantly (P < 0.005) and the central and anterior vertebral body height decreased significantly (P < 0.005) when compared with the PPSF-PVP Group.

Conclusion:
PPSF combined with PVP procedure is a good choice for the treatment of traumatic thoracolumbar VCF; however, due to the lack of long-term follow-up data, concern still exists regarding the effects of pedicle screw procedure after PVP.